- Guidehealth (Philadelphia, PA)
- …Based clinical initiatives. This includes but is not limited to case management , transitions of care, care coordination and continuity, provider/staff education on ... maintain a network of community support. This individual must exhibit strong leadership, management , and interpersonal skills, as well as the ability to utilize both… more
- WellSpan Health (Ephrata, PA)
- …in the management of patient care between visits. Assists in the management of patient utilization of health care system and provides patient education ... a nursing resource for clinical staff. Responsibilities Duties and Responsibilities Remote Work Capable Essential Functions: Obtains patient history and gathers… more
- Johnson and Johnson (Philadelphia, PA)
- …TA and/or Immunology. Must be familiar with Microsoft Word, Excel, PowerPoint, and utilization of computers and remote technologies. Reside in or near ... their skills in agility, applying the competencies of Change Management , Time Management and Innovation. The Sr....PharmD, PhD, MD, or other advanced medical degree NP ( Nurse Practitioner), PA (Physician Assistant), with +3 years relevant… more
- 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 every day. **Position Summary** This is a fully remote role open to candidates with an active RN...to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking… more
- CVS Health (Harrisburg, PA)
- …Must be willing and able to work Monday through Friday, 8:00am to 5:00pm. Utilization management is a 24/7 operation. Work schedules will include weekend/holiday ... reside in EST time zone.** This is a full-time remote position. + Utilizes clinical experience and skills in...+ Managed Care experience + Discharge planning experience + Utilization Management experience **Education** Associates Degree or… more
- Sharecare (Harrisburg, PA)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- Prime Therapeutics (Harrisburg, PA)
- …and drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description** Under supervision, is responsible for performing ... Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt...experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Credentialing… more
- Insight Global (Philadelphia, PA)
- …Active RN License or Active LPN License 2-3 years of clinical experience ( Utilization management or utilization review) Strong computer skills Ability ... looking for HEDIS RNs or LPNs for a partially remote contract position in PA and NJ. PARTIALLY ...of medical records assigned by a Clinical Quality Lead nurse . Miles will be reimbursed for any travel. Computer… more
- Magellan Health Services (Somerset, PA)
- …Strong organization, time management and communication skills.* Knowledge of utilization management procedures, mental health and substance abuse community ... Strong organization, time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community… more
- WellSpan Health (Lewisburg, PA)
- …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... as a nursing resource for clinical staff. **Duties and Responsibilities** ** Remote Work Capable** **Essential Functions:** + Obtains patient history and gathers… more
