Utilization Review RN - Utilization Management

Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost-effective care to the members.

Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation 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:

• Nursing school graduate.
• Upon hire: California Registered Nurse License.
• 3 years' experience in utilization management and/or case management.
• 3 years Clinical experience in hospital or medical office/clinic setting.
• Experience with Milliman criteria.

Preferred Qualifications:

• Bachelor's Degree in Nursing or related field.
• Upon hire: Certification in Case Management (CCM).

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.