- CVS Health (Harrisburg, PA)
- …all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit ... solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other… more
- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Cognizant (Harrisburg, PA)
- …background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan + 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- Highmark Health (Harrisburg, PA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... setting **Preferred** + Experience in UM/CM/QA/Managed Care + Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience… more
- Penn Medicine (Lancaster, PA)
- …Medicine Lancaster General Health is looking for an experienced RN to join our Utilization Management Specialist team! In this critical role, you'll advocate for ... we'd love to hear from you!_ **Summary** : The Utilization Management Specialist - Admissions is responsible...**Minimum Required Qualifications:** + Current licensure as a Registered Nurse , issued by the Pennsylvania Board of Nursing +… more
- WellSpan Health (York, PA)
- …**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 + Registered Nurse… more
- 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 (Chambersburg, PA)
- …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... year Clinical nursing experience. Required **Licenses:** + Licensed Practical Nurse Upon Hire Required or + Licensed Practical ...Nurse Upon Hire Required or + Licensed Practical Nurse Multi State License Upon Hire Required or +… more
- WellSpan Health (Lebanon, PA)
- …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... year Clinical nursing experience. Required **Licenses:** + Licensed Practical Nurse Upon Hire Required or + Licensed Practical ...Nurse Upon Hire Required or + Licensed Practical Nurse Multi State License Upon Hire Required or +… more
- UPMC (Pittsburgh, PA)
- …of health insurance experience preferred. + 1 year of experience in clinical, utilization management , home care, discharge planning, and/or case management ... UPMC Your Care is Hiring a Full-Time Registered Nurse for a Nurse Clinical Care...and social history, current medications, geriatric syndromes, healthcare resource utilization , and case management interventions. Updates the… more