Care Manager, RN – Utilization Management

🔥 15 hours ago

🏄 California – Remote

🏄 California – Remote

💵 $57 - $88 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Providence

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1856

💼 Consulting

🛡️ Insurance

🏥 Healthcare

Consulting • Insurance • Healthcare

Providence is a not-for-profit health system committed to providing a wide range of medical services, including primary care, urgent care, pediatrics, maternity care, cancer treatment, and specialized services like neurosurgery and orthopedics. They offer both in-person and virtual care through clinics and a mobile app, ensuring patients can access healthcare conveniently. With a mission rooted in compassion, dignity, and justice, Providence emphasizes serving those who are vulnerable and strives for excellence in healthcare delivery. They are involved in research and innovation, including genomic profiling and clinical trials to improve patient outcomes.

📋 Description

• Provide overall management and communication of clinically-based appeals between Providence Health and Services, California Region, and outside payers • Keep activities patient-focused, uniform, and compliant • Advocate for reimbursement of services provided to patients served within Providence Health and Services ministries

🎯 Requirements

• Associate's Degree in Nursing • Upon hire: California Registered Nurse License • 4 years direct patient care experience in an acute hospital setting • 4 years experience as a case manager in an acute hospital setting • Preferred: Bachelor's Degree in Nursing or Master's Degree in Nursing • Preferred: Upon hire, case management certification • Preferred: Experience working with denials and appeals in/for an acute care setting • Preferred: Experience in a multi-hospital and/or integrated healthcare system

🏖️ Benefits

• Retirement 401(k) Savings Plan with employer matching • Health care benefits (medical, dental, vision) • Life insurance • Disability insurance • Paid parental leave • Vacation and holiday time off • Health-related time off benefits • Voluntary benefits • Well-being resources • Additional compensation may be available through shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities