RN Utilization Review - Per Diem - REMOTE

Overview

RN Utilization Review at Irvine, CA. This position is Per Diem and will work Remote 8‑hour, Day shifts.

Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and medical record reviews daily during admission for all payers, as required by the health plans. This role requires a strong clinical background combined with well‑developed knowledge and skills in Utilization Management, medical necessity, and patient status determination. The Utilization Management RN must 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 in Nursing
• Upon hire:
  California Registered Nurse License
• 2 years experience working in a remote UR environment or working as an acute hospital case manager.

Preferred Qualifications:

• Bachelor's Degree in Nursing
• Master's Degree in Nursing
• Experience working with Interqual guidelines.
• Experience in a multi-hospital and/or integrated healthcare system.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, paid parental leave, vacations, holidays, and well‑being resources. Shift differentials and overtime are available for eligible work hours.

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, 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.