Utilization Review LPN LVN - Utilization Management

Posted Yesterday
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Mission Hills, CA, USA
In-Office
Junior
Healthtech
The Role
Performs utilization review and care management activities within a multidisciplinary team. Coordinates resources, communicates with patients, clinicians, and caregivers, documents case reviews, and ensures appropriate, cost-effective care across the care continuum.
Summary Generated by Built In

Care Management is a collaborative practice model including the patients, nurses, social workers, physicians, other practitioners, caregivers and the community. The care management process encompasses excellent communication, both verbal and written, and facilitates care along a continuum through effective resource coordination.

Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation 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 Healthcare or high school diploma or GED with graduation from an accredited nursing program from a college or vocational school with 2 years’ related work experience.
  • Upon hire: California Licensed Vocational Nurse.
  • 2 years Clinical experience in an HMO, medical group, affiliated model, hospital or medical office/clinic setting.

Preferred Qualifications:

  • Bachelor's Degree in Healthcare related field.    
  • 3 years' experience in utilization management or case management.

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.

About Us
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.

Posted are the minimum and the maximum wage rates on the wage range for this position.  The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts 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.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
About the TeamProvidence Clinical Network (PCN)  is a service line within Providence serving patients across seven states with quality, compassionate, coordinated care. Collectively, our medical groups and affiliate practices are the third largest group in the country with over 11,000 providers, 900 clinics and 30,000 caregivers.
PCN is comprised of Providence Medical Group in Alaska, Washington, Montana and Oregon; Swedish Medical Group in Washington’s greater Puget Sound area, Pacific Medical Centers in western Washington; Kadlec in southeast Washington; Providence’s St. John’s Medical Foundation in Southern California; Providence Medical Institute in Southern California; Providence Facey Medical Foundation in Southern California; Providence Medical Foundation in Northern and Southern California; and Covenant Medical Group and Covenant Health Partners in west Texas and eastern New Mexico.
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.

Skills Required

  • Associate's Degree in Healthcare OR high school diploma/GED plus graduation from an accredited nursing program with 2 years' related work experience
  • California Licensed Vocational Nurse (LVN) upon hire
  • 2 years clinical experience in an HMO, medical group, affiliated model, hospital, or medical office/clinic setting
  • Bachelor's Degree in a healthcare-related field
  • 3 years' experience in utilization management or case management

Providence Health & Services Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Providence Health & Services and has not been reviewed or approved by Providence Health & Services.

  • Healthcare Strength Coverage spans medical, dental, and vision, with robust mental health support including up to 25 free therapy sessions and a well‑being platform. Additional resources like caregiver assistance and plan assistance can bolster access and overall health support depending on location and eligibility.
  • Retirement Support A 401(k) with employer match and an additional discretionary contribution, plus a student‑debt retirement savings match, provide meaningful long‑term savings support. Planning tools and Public Service Loan Forgiveness eligibility further strengthen the financial security package.
  • Parental & Family Support Back‑up child and elder care through Bright Horizons and paid parental leave offer practical support for caregiving needs. Relocation assistance and other family‑oriented resources complement the core benefits where available.

Providence Health & Services Insights

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The Company
HQ: Portland, OR
20,990 Employees

What We Do

At Providence, our strength begins with understanding. We take time to see, hear and value everyone who walks through our doors—patient or caregiver, family support person or volunteer. Working with us means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others.

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