• Utilization Management Nurse

    Humana (Harrisburg, PA)
    …help us put health first** Full-Time, Remote Telephonic opportunity 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...Time **Required Qualifications** + Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in… more
    Humana (09/12/25)
    - Related Jobs
  • SNF Utilization Management RN…

    Humana (Harrisburg, PA)
    …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (09/12/25)
    - Related Jobs
  • Utilization Management Nurse

    Humana (Harrisburg, PA)
    …our caring community and help us put health first** The Weekend 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
    Humana (10/18/25)
    - Related Jobs
  • Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. ... not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + Minimum... Nursing . + At least 1 year of Utilization Management experience in concurrent review or… more
    CVS Health (10/21/25)
    - Related Jobs
  • Clinical Registered Nurse

    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
    Cognizant (10/07/25)
    - Related Jobs
  • Specialist (Part-time) - Utilization

    Penn State Health (Hershey, PA)
    …compliance with the CMS Conditions of Participation for Utilization Management . **MINIMUM QUALIFICATION(S):** + Bachelors Degree in Nursing or Masters ... required. + Currently licensed to practice as a Registered Nurse by state of employment or holds a multistate...Healthcare Pennsylvania **Position** Specialist (Part-time) - Utilization Management **Location** US:PA: Hershey | Nursing |… more
    Penn State Health (10/21/25)
    - Related Jobs
  • Utilization Management

    Humana (Harrisburg, PA)
    …put health first** The UM Administration Coordinator contributes to administration of utilization management . The UM Administration Coordinator 2 performs varied ... treatment, care or services for members utilizing Home Health and Skilled Nursing Facility services. This team sits in the Home Solutions organization and… more
    Humana (10/10/25)
    - Related Jobs
  • Utilization Management Clinician-…

    CVS Health (Harrisburg, PA)
    …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
    CVS Health (10/21/25)
    - Related Jobs
  • Registered Nurse - Case Manager - PRN

    WellSpan Health (Lebanon, PA)
    …Acute Care experience. Required + Field of experience in Utilization Management , Case Management , or Clinical Nursing Specialty. Preferred **Licenses:** ... and Responsibilities** + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for... Nurse Upon Hire Required or + Registered Nurse Multi State License Upon Hire Required and +… more
    WellSpan Health (10/15/25)
    - Related Jobs
  • RN Acute Case Manager - System Care…

    Guthrie (Sayre, PA)
    …recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care in collaboration with ... Arts (BA) degree in addition to a degree in Nursing . A registered nurse with five (5)...admissions and short procedures by translating clinical information to Utilization Management requirements using pre‐determined criteria. b.… more
    Guthrie (10/15/25)
    - Related Jobs