The RN Case Mgr/UR serves as a primary source to coordinate and communicate the financial management, interdisciplinary clinical service delivery, utilization of resources, and discharge planning for assigned patients beginning prior to admission, throughout the inpatient stay, and upon discharge.

This caregiver is responsible for combining clinical, business and regulatory knowledge and skill to reduce significant financial risk and exposure caused by concurrent and retrospective denial of payments for services provided.  Performs preadmission, concurrent, and retrospective reviews of the medical record using pre-established, objective, quality of care, coding, and medical necessity criteria to monitor patient care rendered. Provides decision support by communicating findings, to Director of Case Management, physician, or others.  Refers complex cases to Care Management Team.

Providence caregivers are not simply valued – they’re invaluable. Join our team at St Elias Specialty Hospital 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.

Hours: Full-time, 1.0 FTE, Day Shift, 40 Hours Per Week

Apply today! Applicants that meet qualifications will receive an invite with additional screening questions from our HireVue system!

 

Required Qualifications:

Registered Nursing degree/diploma. All Registered Nurses without a minimum of a Bachelor’s degree in Nursing must obtain a Bachelor’s degree or higher within 3 years of hire. Upon hire: Alaska Registered Nurse License. 2 years Clinical nursing experience.

Preferred Qualifications:

Bachelor's Degree  3 years Clinical nursing experience. 1 year Utilization Management-review experience, AND Discharge-planning experience.

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.

The Providence family of organizations has a vision of health for a better world. As such, we are called to care wisely for our communities, resources, and earth. Our organizations strive to become carbon negative by 2030.

Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.