LVN/RN, UTILIZATION MANAGEMENT NURSE SPECIALIST, (PHP), CARE MANAGEMENT, WHITTIER, FULL TIME, DAYS - Full-time / Part-time

We’re a nonprofit, regional healthcare network with two hospitals, numerous outpatient medical offices, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer and emergency services. Our leadership is dedicated to putting patients first—a cornerstone of our mission, vision and values—as we deliver top-quality healthcare.

From our extensive facilities in Whittier, California and Downey, California, PIH Health serves more than two million residents in Los Angeles and Orange Counties and throughout the San Gabriel Valley.

The UM Nurse Specialist provides organizational support in the Utilization Management Department; efficiently processes Pre-Service Authorization Requests. Works with UM Coordinators. 

Required Skills

• Current knowledge of Managed Care and Health Plan Division of Financial Responsibilities (DOFR)


• Ability to apply appropriate UM criteria


• Excellent communication skills


• Strong organizational capabilities.

Required Experience

• Formal training will be indicated by a high school diploma or equivalent


• Current licensure as a RN or LVN in the state of California.


• Minimum two years’ experience in a health plan or managed care IPA or Medical Group in UM.

 

Beyond the benefits that come with working for the area's leading community healthcare provider – one that also recognizes the need to ensure patient safety and comfort – you'll enjoy an extremely competitive compensation and benefits package.  We are an equal opportunity employer and seek diversity in our workforce.   EOE M/F/D/V