- Prime Therapeutics (Harrisburg, PA)
- …Patient Programs. **Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... of post-degree clinical experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Credentialing criteria. + At… more
- CenterWell (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... high-volume community or mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or Bachelor's degree in a… more
- Geisinger (Danville, PA)
- Job Summary Geisinger is proud to offer a full time Inpatient Licensed Practical Nurse (LPN) a $10,000 sign on bonus for eligible candidates as well as up to $40,000 ... and advancement + Support and mentorship from a full range of dedicated nursing leaders + Community involvement through our Employee Resource Groups + Employee… more
- WellSpan Health (York, PA)
- …Intensive Care experience preferred + Field of Experience in Utilization Management , Case Management , or Clinical Nursing Specialty. Preferred ... principles. **Essential Functions:** + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for continued… more
- ChenMed (Philadelphia, PA)
- …Ability to plan, implement and evaluate individual patient care plans + Knowledge of nursing and case management theory and practice + Knowledge of patient care ... working remote for the remaining hours. The Acute Care Manager , Complex Care (RN) is responsible for achieving positive...required + A minimum of one (1) year of utilization review and/or case management , home health,… more
- Guthrie (Sayre, PA)
- …State of Pennsylvania/New York. Certification within area of expertise or practice preferred ( Nursing Management , CCRN, CEN, etc.) BSN required within 3 years of ... impact on practice in the planning and delivery of nursing and other services. Utilizes staffing management ...care. Manages daily staffing issues in conjunction with Charge Nurse / Nurse Manager , analyzing… more
- Veterans Affairs, Veterans Health Administration (Butler, PA)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... within our Community Care Section as an RN Care Manager . Community Care at the VA provides care to...requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse… more
- Genesis Healthcare (York, PA)
- …years of clinical nursing experience is required. Prior experience in utilization review, case management or discharge planning is required. Prior experience ... meaningful impact in the communities we serve. Responsibilities The Manager , Case Management is responsible for the...state where employment occurs is required. Bachelor's Degree in Nursing preferred. Certified Case Management (CCM) or… more
- Penn Medicine (Philadelphia, PA)
- …Nurse - PA (Required) + 5yrs prior experience as a Nurse Case Manager with knowledge of utilization review and 3rd Party Payors (Required) + Pennsylvania ... not limited to admissions, patient financial services, clinical resource management and provider medical staff and designees.Assist in preparation...years Prior experience as a nurse case manager with knowledge of utilization review and… more
- UPMC (Washington, PA)
- The Manager oversees the day-to-day operations of the Case management department under the direction of the Director. The Manager is accountable for the ... care/treatment, The Joint Commission Standards, Federal/State regulations relative to utilization /case management , discharge planning, Medicare, Medicaid, and… more