Providence St. Joseph Health

Job Information

St. Joseph Health / Covenant Health Utilization Management RN Coordinator in Anaheim, California

We are looking for a Utilization Management RN Coordinator - with HSS Ambulatory UM at CA Anaheim West Center 200.

Location : California, Anaheim

Schedule : Full-time

Shift : Day

Apply Today! Applicants that meet qualifications will receive a text with some additional questions from our Modern Hire system.

Job Summary :

Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members.


o Knowledge of utilization management, case management and healthcare provided throughout the continuum.

o Ability to problem solve.

o Ability to handle multiple tasks at a time and remain organized.

o Ability to work autonomously but also as a team member.

o Proficiency in Excel, Access, and Word computer applications preferred.



Position Requirements :


Nursing school graduate.


3 years Experience in utilization management and/or case management.

3 years Clinical experience in hospital or medical office/clinic setting.

Experience with Milliman criteria.


o Active California RN license.

o Certification in Case Management (CCM) preferred.


Preferred Position Qualifications :


Bachelor's Degree Nursing or related field.

Mission Heritage Medical Group is one of California's most respected medical groups. With over 3,000 employees and 75 locations throughout California, including, Northern California, Orange County, High Desert and Los Angeles County, Mission Heritage Medical Group has been continually recognized as a leader in quality, customer service and information technology. This kind of success is the result of team work, a commitment to excellence and a strong adherence to the organization's mission, vision and values.Mission Heritage Medical Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Mission Heritage Medical Group complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Company: Heritage Healthcare

Category: Quality Nursing

Req ID: R329831