Care Manager - Appeals RN - Utilization Management

Care Manager Appeals RN - REMOTE position. This position is Per Diem and will work 8- hour, Day shifts.

The Care Management Recovery Advocate (CMRA) is responsible for providing overall management and communication of clinically-based appeals between Providence Health and Services, California Region (PH&S) outside payers. Activities will be patient-focused, uniform, compliant, and support steadfast advocacy for reimbursement of services provided to patients served within the PH&S ministries.

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:

• Associate's Degree in Nursing.
• California Registered Nurse License upon hire
• 4 years direct patient care experience in an acute hospital setting.
• 4 years experience as a case manager in an acute hospital setting.

Preferred Qualifications:

• Bachelor's Degree in Nursing. -Or-
• Master's Degree in Nursing
• Case management certification upon hire
• Experience working with denials and appeals in/for an acute care setting.
• 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.