Utilization Review RN
On-site · Mission Hills, California, United States
Job Summary
Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Join Providence Medical Foundation and contribute to patient-focused, whole-person care. Requires California RN license upon hire, 3 years of utilization management/case management experience, 3 years of clinical experience in hospital or medical office/clinic settings, and familiarity with Milliman criteria. Preferred: Bachelor's Degree in Nursing or related field; CCM certification upon hire.
Required Qualifications
- Nursing school graduate
- California Registered Nurse License upon hire
- 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
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