Position Summary
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 a four‑time designated Magnet® hospital, one of only 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, meaning only 1% of U.S. hospitals are four times designated.
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, as required by the health plans.
Utilize strong clinical background combined with well‑developed knowledge and skills in Utilization Management, medical necessity, and patient status determination.
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.
Required Qualifications
Associate's Degree – Nursing.
California Registered Nurse License upon hire.
2 years of experience working in a remote UR environment or 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.
About Providence
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 foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers 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.
About the Team
The Sisters of Providence and Sisters of St. Joseph of Orange have deep roots in California, bringing health care and education to communities from the Redwood forests to the beach shores of Orange County and everywhere in between. In Southern California, Providence provides care throughout Los Angeles County, Orange County, High Desert and beyond.
Equal Opportunity Statement
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Job Details
Job Category: Health Information Management
Job Function: Revenue Cycle
Job Schedule: Part time
Job Shift: Day
Career Track: Nursing
Department: 7000 UTILIZATION MGMT REMOTE
Address: CA Mission Hills 15031 Rinaldi St
Work Location: Providence Holy Cross Medical Ctr-Mission Hills
Workplace Type: On‑site
Pay Range: $56.44 - $87.63 per hour
Additional compensation may be available for this role, such as shift differentials, standby/on‑call, overtime, premiums, extra shift incentives, or bonus opportunities.
Contact and Application
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.
To learn more about our benefits, visit providence.jobs/benefits.
Requisition ID: 396717
Company: Providence Jobs
Job Category: Health Information Management
Job Function: Revenue Cycle
Job Schedule: Part time
Job Shift: Day
Career Track: Nursing
Department: 7000 UTILIZATION MGMT REMOTE
Last posted: 1 week ago – “Be among the first 25 applicants”.