• RN Registered Nurse Utilization

    Penn State Health (Hershey, PA)
    … or genetic information._ **Union:** SEIU Healthcare Pennsylvania **Position** RN Registered Nurse Utilization Management Specialist - Utilization Management ... at ###@pennstatehealth.psu.edu (MAILTO://###@pennstatehealth.psu.edu) **SUMMARY OF POSITION:** Responsible for the review of clinical documentation in the Electronic Medical more
    Penn State Health (08/20/25)
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  • Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    …solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. ... (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible,...experience in Nursing. + At least 1 year of Utilization Management experience in concurrent review or… more
    CVS Health (09/02/25)
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  • Utilization Review RN Case Manager…

    Penn Medicine (Philadelphia, PA)
    …or Equivalent Experience: + Bachelor of Arts or Science (Required) + Utilization Review experience (Required) + Bachelor's Degree in Nursing required.2+ ... leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across… more
    Penn Medicine (08/19/25)
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  • Nurse Manager 1

    Commonwealth of Pennsylvania (PA)
    …I have professional experience performing this Work Behavior as a charge nurse , head nurse , utilization review nurse , quality assurance nurse , or ... documenting daily care in the designated forms and electronic medical records. Interested in learning more? Additional details regarding...Work Behavior as a charge nurse , head nurse , utilization review nurse more
    Commonwealth of Pennsylvania (08/29/25)
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  • Nurse Clinical Care Coord -Allegheny County

    UPMC (Pittsburgh, PA)
    …face-to-face assessments that include a clinical assessment and treatment, a review of the medical , functional, behavioral, pharmaceutical, and social ... **UPMC Your Care is Hiring a Full-Time Registered Nurse for a Nurse Clinical Care...collaboration with members, their caregivers, and providers. Identifies members' medical , behavioral, and social needs, as well as barriers… more
    UPMC (08/13/25)
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  • Licensed Practical Nurse -Outpatient…

    WellSpan Health (Chambersburg, PA)
    …and patient has been notified. Provides related education, counseling, ongoing review , and monitoring regarding diagnostic tests (ie, INR results in Anticoagulation ... of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education relative to health care… more
    WellSpan Health (08/01/25)
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  • RN - Graduate Registered Nurse (Geisinger…

    Geisinger (Scranton, PA)
    …Click here to learn moreabout the units below + Advanced Acute Care ( Medical & Oncology, Surgical Trauma, Cardiac/Telemetry, Orthopedics) + Cardiac Special Care Unit ... & Children's Perks of joining Geisinger as a Graduate Nurse ! + Offer GNs up to a year in...on the specialized practice setting + Free Princeton NCLEX Review Questions (on-line, self paced)! + Temporary Practice Permit… more
    Geisinger (07/31/25)
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  • R&E Nurse - Med Care Services- Expert

    Health Advocates Network (Harrisburg, PA)
    …setting, behavioral health setting, drug and alcohol setting, managed care, quality management/ utilization review or other related clinical experience; or An ... (MA), health care services, human services, long term care, utilization review , or knowledge of home care...review . Role Description: This is work in the review and evaluation of the medical necessity,… more
    Health Advocates Network (08/28/25)
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  • Clinical Reviewer, Nurse

    Evolent (Harrisburg, PA)
    …team approach with call center staff. Clinical Reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + ... it. **What You'll Be Doing:** As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way… more
    Evolent (08/19/25)
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  • Clinical Reviewer, Nurse -Surgery

    Evolent (Harrisburg, PA)
    …team approach with call center staff. Clinical Reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + ... culture. **What You'll Be Doing:** As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way… more
    Evolent (08/19/25)
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