The Manager of Utilization Management provides a key role in leading, facilitating and managing the hospital utilization management program in the Southern California Region.
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.
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.
Why Join Providence?
Our ” target=”_blank” rel=”nofollow”>Mission of caring for everyone, especially the most vulnerable in our communities.
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.
Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women’s services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care, and even our own Providence High School.
Providence is proud to be an ” target=”_blank” rel=”nofollow”>diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.