- 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… more
- Geisinger (Wilkes-Barre, PA)
- …and efficiency results for assigned population. + Works to appropriately apply benefits and utilization management serving as a resource to the patient or member ... patient care and enhance the professional impact of our RN Case Managers. Geisinger's Care Without Delay (CWD) is...Basic Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania… more
- WellSpan Health (York, PA)
- …principles. **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 +… more
- St. Luke's University Health Network (Lehighton, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the ... the continuum of care. Also works with the providers, registered nurse care managers, social workers, and...including but not limited to: Social workers, assistants, coordinators, utilization management staff, and director. + Facilitates… more
- CVS Health (Harrisburg, PA)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... is URAC accredited in Case Management , Disease Management and Utilization Management . AHH...in a hospital setting. + A Registered Nurse that holds an active, unrestricted… more
- Evolent (Harrisburg, PA)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management ...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
- St. Luke's University Health Network (Bethlehem, PA)
- …, including but not limited to: Social workers, assistants, coordinators, utilization management staff, and director. + Facilitates communication among ... a patient's ability to pay for health care. The RN Care Manager coordinates the overall progression of care,...touch as related to telephone and computer keyboard. EDUCATION: Registered Nurse with current license to practice… more
- WellSpan Health (York, PA)
- …or neuro nursing required + Previous quality assessment and utilization management experience preferred **Licenses:** + Licensed Registered Nurse Upon ... areas that require attention. Is responsible for all program management , report generation and review, process improvement, patient satisfaction...Hire Required or + Registered Nurse Multi State License Upon Hire Required **Courses and… more
- Genesis Healthcare (Camp Hill, PA)
- …ADON or ADON - Unit, or Director of Nursing ( Nurse Leader), the Registered Nurse ( RN ) delivers efficient and effective nursing care while achieving ... to achieve patient goals and minimize rehospitalizations; 4.4. Actively participates in Utilization Management or InterdisciplinaryCare Management Meeting to… more
- LifePoint Health (Johnstown, PA)
- …in employment. **Job:** **Nursing* **Organization:** ** **Title:** * Registered Nurse ( RN )- Case Management PRN/Hourly* **Location:** ... * Registered Nurse ( RN ), Case Manager...in the care of hospitalized patients. Our team of RN Case Managers, Social Workers, Utilization Review staff,… more