Providence Health & Services
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
ReqID: 424644 Company: Providence Job Category: Nursing-Patient Facing Shift: Day Schedule: Full time Work Location: Providence System Offices Discovery Park-Irvine The Manager of Utilization Management provides a key role in leading, facilitating and managing the hospital utilization management program in the Southern California Region. 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: Bachelor's Degree in Nursing or other related area Upon hire: California Registered Nurse License 5 years healthcare management experience related to acute care utilization management or appeals management. Preferred Qualifications: Master's Degree in Nursing or other related area Coursework/Training: Case Management Certification 2 years minimum of two years direct patient care experience in an acute care setting is preferred. Other direct patient care experience may consider in lieu of acute care. Previous experience working with denials and appeals in/for an acute care setting. Previous experience working with a remote UR team. Previous experience as a case manager in an acute care setting.
The Manager assists the Regional Director of Utilization Management, Appeals & Clinical Training through the provision of ongoing assessment and evaluation of hospital activities related to patient admission, transfers, and discharges in a variety of clinical settings. Accomplishes results through multiple experienced individual staff members who exercise latitude and independence in their assignments. Fosters team collaboration, sharing of workload and enhanced productivity.
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