- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization Management ... documentation and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works… more
- Guthrie (Sayre, 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 criteria. b.… more
- UPMC (Pittsburgh, PA)
- Are you a registered nurse with a background in utilization management ? Are you interested in the opportunity to work from home? UPMC Health Plan is looking ... for you! We are hiring a full-time Utilization Management Care Manager to...2 years of experience in a clinical and/or case management nursing required. + Minimum of 1-year… more
- Penn Medicine (Philadelphia, PA)
- …their critical thinking skills and being a strong patient advocate. The case manager conducts utilization management activities, communication with insurers, ... fearful you will miss patient contact? If so, our nurse case manager role at Penn Medicine...community resources, transportation, and quality data collection and risk management referral. + Responsibilities: Utilization management… more
- Geisinger (Pittston, PA)
- …base clinically and administratively through active participation in professional, and educational nursing activities to enhance skills as manager , leader, and ... professional development supervisor with development and ongoing maintenance of New Manager Training Program, Ambulatory Nurse Leader program, and developing,… 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
- 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
- Penn Medicine (Philadelphia, PA)
- …you living your life's work? Summary: + The role of the Integrated Clinical Nurse Manager is an integrated role within the Oncology service line/Cancer Service ... Line (CSL). The Integrated Clinical Nurse Manager is responsible for assisting clinical and administrative leadership with the management of practice and… 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
- St. Luke's University Health Network (Orwigsburg, 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
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