RN Utilization Review Part- time Remote

Remote, USA Full-time
RN Utilization Review at Providence Holy Cross Medical Center in Mission Hills, CA. This position is Part- time and will work 8-hour, Day shifts. Providence Holy Cross Medical Center is four-time designated for Magnet® status, the highest recognition for nursing excellence, making it one of just four hospitals in California to achieve this status. Since 2007, Holy Cross has been recognized as a Magnet® hospital—a prestigious designation from the American Nurses Credentialing Center (ANCC), which recognizes organizations that provide the highest-quality care. Only 9.96% of U.S. hospitals earn Magnet® recognition, which means that only 1% of U.S. hospitals are four times designated. Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required by the health plans. This role requires a strong clinical background combined with well-developed knowledge and skills in Utilization Management, medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a diverse workload in a fast-paced, rapidly changing regulatory environment, demonstrating excellent negotiation, communication, problem-solving, and decision-making skills. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence California Regional Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required Qualifications: • Associate's Degree - Nursing. • California Registered Nurse License upon hire. • 2 years - Experience working in a remote UR environment or working as an acute hospital case manager. Preferred Qualifications: • Bachelor's Degree - Nursing. • Master's Degree - Nursing. • Experience working with Interqual guidelines. • Experience in a multi-hospital and/or integrated healthcare system. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. Apply tot his job
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