- Guthrie (Troy, PA)
- …approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of ... Arts (BA) degree in addition to a degree in Nursing . A registered nurse with five (5)...admissions and short procedures by translating clinical information to Utilization Management requirements using pre ‐ determined… more
- CenterWell (Harrisburg, PA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... unrestricted RN license with the ability to obtain Compact Nursing License + A minimum of three years clinical...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- AmeriHealth Caritas (Philadelphia, PA)
- …us at www.amerihealthcaritas.com . **Responsibilities:** Under the supervision of the LTSS Manager /Director for Utilization Management , this position is ... Home Modification Team and staff members within the LTSS Review Utilization Management Department. Responsibilities include providing technical and operational… more
- Penn Medicine (Lancaster, PA)
- …and assists nursing personnel in assessing patient family status to plan of nursing care. + Assists Nurse Manager in evaluating and setting standards ... + Position Summary: + Under the direction of the Nurse Manager , the Assistant Nurse ...works with the medical staff to coordinate medical and nursing management of patient care. + Assists… more
- Veterans Affairs, Veterans Health Administration (Coatesville, PA)
- Summary The Mental Health Substance Treatment Program (STP) Registered Nurse Manager (NM) executes position responsibilities to improve patient and ... and clinical support. Responsibilities The MH Substance Treatment Program (STP) Registered Nurse Manager (NM) responsible and accountable for all elements of… more
- WellSpan Health (Lebanon, PA)
- …Acute Care experience. Required + Field of experience in Utilization Management , Case Management , or Clinical Nursing Specialty. Preferred **Licenses:** ... **Duties and Responsibilities** + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for continued… more
- St. Luke's University Health Network (Stroudsburg, PA)
- …, including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director. . Facilitates communication among all ... patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is...Perinatal Social Workers is required. OR: Graduate of professional nursing program. Registered Nurse with current license… more
- St. Luke's University Health Network (Quakertown, PA)
- …, including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director. + Facilitates communication among all ... patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is...Perinatal Social Workers is required. OR: Graduate of professional nursing program. Registered Nurse with current license… more
- Penn Medicine (Philadelphia, PA)
- …of Obstetric Anesthesia and Perinatology Center of Excellence Award Summary: + Assists Nurse Manager by assuming 24-hour accountability for the operation of the ... the principles of Relationship Based Care and effective communication. * Supports the Nurse Manager in establishing/updating processes and work practices for the… more
- Geisinger (Danville, PA)
- …and efficiency results for assigned population. + Works to appropriately apply benefits and utilization management serving as a resource to the patient or member ... Specialty Training Program- Nursing (Required) Experience Minimum of 2 years- Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse … more
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