Providence Health & Services UM / QM - LVN Case Manager in Los Angeles, CA in Los Angeles, California


Providence is calling a Utilization Review LVN Case Manager ( Full Time / Day Shift ) at our Providence Medical Institute Axminster Managed Care location in Los Angeles, CA.

In this position you will:

  • Be responsible for utilization review and discharge planning for patients who are hospitalized.

  • The review includes coordination of services for medical necessity, cost effectiveness, timelines of service and ensuring that quality standards are met.

  • Perform coordination of services for patients whose health plan has an at-risk agreement to ensure that services are medically necessary, cost effective, provided in a timely manner and meet local standards or care.


Required qualifications for this position include:

  • Graduate of an accredited LVN school of nursing.

  • Current California LVN license.

  • Current Basic Life Support (BLS) certification for Health Care Providers from the American Heart Association.

  • Basic knowledge of disease processes, ability to prioritize medical conditions and to use effective nursing judgment in problem solving.

  • Demonstrates proper phone etiquette, strong computer skills including knowledge of Word and Excel.

  • Must have extensive knowledge of health plan requirements and benefits as applied to the utilization and case management process.

Preferred qualifications for this position include:

  • Hospital inpatient case management or ambulatory case management experience.

About the location you will serve:

Providence Health & Services Southern California is further developing its physician integration strategy. Historically, the largest asset has been Providence Medical Institute, a medical foundation that provides administrative and other support services to affiliated medical groups. Providence Medical Institute is expected to grow significantly in the next several years, bringing with it facilities, staff and physician growth to support that objective.

We offer a full comprehensive range of benefits - see our website for details

Our Mission

As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.

About Us

Providence Health & Services is the third largest not-for-profit health system in the United States. Providence employs more than 82,000 caregivers (employees) across a five-state area; AK, WA, MT, OR, and CA. Our facilities include 34 hospitals, 600 physician clinics, senior services, supportive housing and other health and educational services. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate 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.

Schedule: Full-time

Shift: Day

Job Category: Case Management

Location: California-Los Angeles

Req ID: 159032