- WellSpan Health (Waynesboro, PA)
- …Required **Work Experience:** + 2 years Recent acute care experience. Required + Utilization management , care management , or clinical nursing specialty. ... **General Summary** Performs a variety of duties and applies utilization and care management techniques to determine...Preferred **Licenses:** + Licensed Registered Nurse Upon… more
- CVS Health (Jersey Shore, PA)
- …new hires upon achieving proficiency in the role. **Required Qualifications** + Active, unrestricted ** Registered Nurse ( RN ) license in New Jersey** . + ... high-quality, cost-effective care for our members. These strategies encompass utilization management , quality improvement, network coordination, and clinical… more
- WellSpan Health (York, PA)
- …experience. Required + Lean Daily Management experience. Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered Nurse ... safety and efficient care. Assists the Director of Clinical Operations in management of staff to deliver high quality, patient-centered care. Assists with directing… more
- Veterans Affairs, Veterans Health Administration (Lebanon, PA)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... Community Care service line. Responsibilities The Women's Health Case Manager ( RN ) is responsible for executing a...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- WellSpan Health (Gettysburg, PA)
- …Degree Required **Work Experience:** + 1 year Relevant experience. Required **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered ... plan of care, the patient's diagnosis, corporate policy and procedures and the Nurse Practice Act. Carries primary care management functions for assigned… more
- Veterans Affairs, Veterans Health Administration (Lebanon, PA)
- …line. Responsibilities The Domiciliary Mental Health (MH) Registered Nurse ( RN ) supports the Nurse Manager (NM) with duties and responsibility ... education, orientation, competencies and providing quality improvement and outcomes utilization consultation. The domiciliary RN provides patient-centered and… 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 ... ; **Education/ Experience:;** + Bachelor's degree or equivalent relevant experience + Unrestricted Registered Nurse ( RN ) or Physical Therapist (PT) + Valid… more
- UPMC (Pittsburgh, PA)
- …Clearances: + Case management certification or approved clinical certification preferred + Registered Nurse ( RN ) *Current licensure either in the state ... Preference will be given to candidates with a Pennsylvania RN license. This role will review requests for authorization...review requests for authorization for behavioral health services. The Utilization Management (UM) Care Manager … more
- Select Medical (Erie, PA)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates...**Current licensure in a clinical discipline either as a Nurse ( RN /LPN/ LVN)or a Respiratory Therapist… more
- WellSpan Health (Lewisburg, PA)
- …principles. **Essential Functions:** + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for continued ... quality and cost of care efforts. + Liaisons between utilization management team, third party payers, and..., or Clinical Nursing Specialty. Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or +… more
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