• Utilization Management Nurse

    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 (07/23/25)
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  • Utilization Management Nurse

    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
    CVS Health (08/01/25)
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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 ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous...culture and much more. Travel: While this is a remote position, occasional travel to Humana's offices for training… more
    CenterWell (08/02/25)
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  • Disease Management Nurse

    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
    Sharecare (07/12/25)
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  • Infusion Referral Nurse - REMOTE

    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
    Prime Therapeutics (07/24/25)
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  • Registered Nurse , Case Manager…

    CVS Health (Harrisburg, PA)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... each and every day. **Position Summary** **This is a remote work from home role anywhere in the US...using a keyboard **Preferred Qualifications** - 1+ years' Case Management experience or discharge planning, nurse navigator… more
    CVS Health (08/01/25)
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  • Case Manager Registered Nurse - Specialty…

    CVS Health (Harrisburg, PA)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... each and every day. **Position Summary** **This is a remote work from home role anywhere in the US...Pharmacy or Oncology.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
    CVS Health (08/01/25)
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  • Nurse - Admission/Placement - Centralized…

    Trinity Health (Newtown Square, PA)
    …previous experience required + 5-8 years previous experience preferred + Knowledge of utilization management ie acuity. + Ability to define appropriate level of ... will be three to six months, then will be remote ._** The Registered Nurse working in the...Planning, Case Management , Leadership, Transfer Center, and Utilization Management ** **Our Commitment** Rooted in our… more
    Trinity Health (07/30/25)
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  • Care Manager, BH - Remote in PA, Bedford,…

    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
    Magellan Health Services (07/16/25)
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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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