Job Description

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.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

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, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

About the Team

Providence has a long history of serving Alaska, beginning when the Sisters of Providence first brought health care to Nome in 1902 during the Gold Rush. This pioneering spirit set the standard for modern health care in Alaska and formed the foundation for Providence's growth as the state's largest private employer and leading health care provider.

Our award-winning and comprehensive medical centers are located in Anchorage, Eagle River, Kodiak Island, Mat-Su, Seward, and Valdez. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, outreach programs, and hospice and home care.

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, sexual orientation, 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.

Requsition ID: 341411
Company: Providence Jobs
Job Category: Care Management
Job Function: Clinical Care
Job Schedule: Full time
Job Shift: Day
Career Track: Nursing
Department: 1003 AK SESH UTILIZ REVIEW
Address: AK Anchorage 4800 Cordova St
Work Location: Providence St Elias Specialty Hospital-Anchorage
Workplace Type: On-site
Pay Range: $49.34 - $76.59
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

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