Role Overview
RN Utilization Review Full‑time Day – Providence Holy Cross Medical Center, Mission Hills, CA. Full‑time 8‑hour day shifts. Magnet® status hospital.
Responsibilities
Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries.
Conduct clinical reviews and review medical records daily during admission for all payers.
Apply knowledge of Utilization Management, medical necessity, and patient status determination.
Manage diverse workload efficiently in a fast‑paced, regulatory environment.
Demonstrate negotiation, communication, problem‑solving, and decision‑making skills.
Required Qualifications
Associate's Degree Nursing.
California Registered Nurse License upon hire.
2 years experience working in a remote UR environment or as an acute hospital case manager.
Preferred Qualifications
Bachelor’s Degree in Nursing.
Master's Degree in Nursing.
Experience with Interqual guidelines.
Experience in a multi‑hospital and/or integrated healthcare system.
Location & Compensation
Work Location: Providence Holy Cross Medical Center – Mission Hills, CA. Pay Range: $56.44–$87.63 per hour (base). Additional compensation may include shift differentials, standby/on‑call, overtime, premiums, extra shift incentives, or bonus opportunities.
Benefits
Comprehensive benefits package including retirement 401(k) plan with employer matching; medical, dental, vision, life insurance; disability insurance; paid parental leave, vacations, holidays; voluntary benefits; well‑being resources. More at providence.jobs/benefits.
EEO Statement
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.