Description
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
- Provide overall management and communication of clinically based appeals between Providence Health and Services, California Region (PH&S) outside payers.
- Ensure activities are patient-focused, uniform, compliant, and support steadfast advocacy for reimbursement of services provided to patients served within the PH&S ministries.
- Collaborate with care teams to optimize approval processes and outcomes.
- Maintain accurate documentation and reporting as required.
About Providence California Regional Services
- 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 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.