Care Manager RN - Utilization Management

Care Manager RN - REMOTE position. This position is Full time 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. Responsibilities are not limited to, but will include: 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 of Direct patient care experience in an acute hospital setting. 4 years of 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