• Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    …and work schedules may include weekends, holidays, and evening hours_ As a Utilization Management Nurse Consultant, you will utilize clinical skills ... Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN...of clinical experience in acute or post-acute setting - Utilization management is a 24/7 operation. Work… more
    CVS Health (08/08/25)
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  • Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    …with heart, each and every day. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. Utilization ... external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working...residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical experience in acute… more
    CVS Health (08/08/25)
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  • Utilization Management Nurse

    CenterWell (Harrisburg, PA)
    …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
    CenterWell (08/08/25)
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  • Utilization Management Nurse

    CenterWell (Harrisburg, PA)
    …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
    CenterWell (08/02/25)
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  • SNF Utilization Management RN…

    Humana (Harrisburg, PA)
    …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the… more
    Humana (08/09/25)
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  • Clinical UM Nurse 2

    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
    CenterWell (08/01/25)
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  • Registered Nurse - Advanced Orthopedic…

    WellSpan Health (York, PA)
    …or neuro nursing required + Previous quality assessment and utilization management experience preferred **Licenses:** + Licensed Registered Nurse Upon Hire ... identifying areas that require attention. Is responsible for all program management , report generation and review, process improvement, patient satisfaction and… more
    WellSpan Health (08/01/25)
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  • Utilization Management Clinical…

    CVS Health (Harrisburg, PA)
    …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
    CVS Health (07/31/25)
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  • Case Management Nurse -RN Weekend…

    WellSpan Health (York, PA)
    …Required **Work Experience:** + 2 years Recent acute care experience. Required + Utilization management , case management , or clinical nursing specialty. ... **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine...Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered … more
    WellSpan Health (07/22/25)
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  • Registered Nurse - Case Manager - Day

    WellSpan Health (Lebanon, PA)
    …**Duties and Responsibilities** + 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 + Registered Nurse more
    WellSpan Health (07/22/25)
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