- 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. ... and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed, ensuring… more
- Penn State Health (Hershey, PA)
- …or genetic information._ **Union:** SEIU Healthcare Pennsylvania **Position** RN Registered Nurse Utilization Management Specialist - Utilization Management ... for maintaining compliance with the CMS Conditions of Participation for Utilization Management. **MINIMUM QUALIFICATION(S):** + Bachelors Degree in Nursing or… more
- Humana (Harrisburg, PA)
- …a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Commonwealth of Pennsylvania (PA)
- …care. + C. I have professional experience performing this Work Behavior as a charge nurse , head nurse , utilization review nurse , quality assurance ... facility. + C. I have experience performing this Work Behavior as a charge nurse , head nurse , utilization review nurse , quality assurance nurse , or… more
- Veterans Affairs, Veterans Health Administration (Wilkes Barre, PA)
- …of nursing education, orientation, competencies and providing quality improvement and outcomes utilization . This nurse has fundamental MH experience with the ... EDRP application. Former EDRP participants ineligible to apply. Responsibilities The Registered Nurse Inpatient Mental Health (MH) Registered Nurse (RN) provides… more
- CVS Health (Harrisburg, PA)
- …skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in clinically ... appropriate treatment, evidence-based care, and medical necessity criteria for appropriate utilization of services for child and adolescent members. + Consults and… more
- Penn Medicine (Philadelphia, PA)
- …quality data collection and risk management referral. Responsibilities: + Utilization management activities: monitor appropriate use of internal resources, ... community resourcesParticipates and drives accountability in daily interdisciplinary meetings Utilization Management:Adheres to guidelines to satisfy 3rd party payer… more
- WellSpan Health (Ephrata, PA)
- …0800 to 1630 **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of resources ... address patient discharge needs. Provides leadership in the integration of utilization and case management principles. **Duties and Responsibilities** + Reviews… more
- WellSpan Health (Lebanon, PA)
- …Weekend rotation **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of ... address patient discharge needs. Provides leadership in the integration of utilization and case management principles. **Duties and Responsibilities** + Reviews… more
- WellSpan Health (York, PA)
- …am to 7 pm **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of resources ... patient care transition needs. Provides leadership in the integration of utilization and case management principles throughout the hospital. **Duties and… more