• Utilization Management Nurse…

    Humana (Harrisburg, PA)
    …and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a… more
    Humana (09/12/25)
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  • RN - Registered Nurse…

    Geisinger (Danville, PA)
    …Specialty Training Program-Nursing (Required) Experience Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; ... Job Summary Please note this is NOT a remote position. Geisinger is proud to offer an Inpatient RN a $41.00 minimum hiring rate with increased rates for… more
    Geisinger (07/24/25)
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  • RN - Registered Nurse…

    Geisinger (Danville, PA)
    …Specialty Training Program-Nursing (Required) Experience Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; ... Job Summary Geisinger is proud to offer a full time Inpatient RN up to $24,000 hiring incentive for eligible candidates! $41.00 minimum hiring rate with increased… more
    Geisinger (10/01/25)
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  • Registered Nurse , Remote…

    ChenMed (Philadelphia, PA)
    …We're rapidly expanding and we need great people to join our team. The Registered Nurse , Remote Triage, is responsible for providing telephonic triage ... and assessments within license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and others on the… more
    ChenMed (09/17/25)
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  • Case Manager, Registered Nurse

    CVS Health (PA)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...or Specialty Pharmacy. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
    CVS Health (10/02/25)
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  • Clinical Resource Coordinator…

    Penn Medicine (Philadelphia, PA)
    …assignment (Outlook, Canopy, CERME, ECIN, shared drive, Internet) Credentials: + Registered Nurse - PA (Required) + PA RN Licensure required. Education or ... work? We are excited to share this rewarding and ** REMOTE RN ** role! This role will focus...community resources, transportation, and quality data collection and risk management referral. Responsibilities: + Utilization management… more
    Penn Medicine (10/02/25)
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  • SNF Utilization Management RN…

    Humana (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse ( RN )** in the… more
    Humana (09/12/25)
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  • RN , Manager, Utilization…

    Humana (Harrisburg, PA)
    …areas. **Use your skills to make an impact** **Required Qualifications** + An active, unrestricted Registered Nurse ( RN ) license in the state of Michigan. + ... community and help us put health first** The Manager, Utilization Management Nursing (LTSS Utilization ...business administration. **Additional Information** + **Workstyle:** This is a remote position. + **Travel:** Up to 25% travel may… more
    Humana (09/28/25)
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  • Utilization Management Nurse…

    CVS Health (Harrisburg, PA)
    …for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. **Key Responsibilities** + Apply critical ... a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM...are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence… more
    CVS Health (10/01/25)
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  • Denials Management Specialist ( RN…

    St. Luke's University Health Network (Allentown, PA)
    …hospital setting required. + Prefer minimum of 2-5 years' experience in case management and/or utilization management . + Prefer financial experience related ... regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical necessity and… more
    St. Luke's University Health Network (08/13/25)
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