• RN Registered Nurse Utilization

    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
    Penn State Health (08/20/25)
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  • Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    …opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal and external ... constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with productivity and… more
    CVS Health (08/24/25)
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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 to ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid… more
    CenterWell (08/02/25)
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  • SNF Utilization Management RN - Compact Rqd

    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
    Humana (08/09/25)
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  • Nurse Manager 1

    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
    Commonwealth of Pennsylvania (08/22/25)
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  • Utilization Review Clinician - Behavioral…

    Centene Corporation (Harrisburg, PA)
    …discharge planning + Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members and their families ... regrading BH utilization process + Interacts with BH healthcare providers as...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
    Centene Corporation (08/22/25)
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  • Utilization Review RN Case Manager - Penn…

    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
    Penn Medicine (08/19/25)
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  • Registered Nurse - Case Manager

    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 (08/24/25)
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  • Registered Nurse - Case Manager - Day

    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 (07/22/25)
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  • Case Management Nurse -RN Weekend Option 3…

    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
    WellSpan Health (08/19/25)
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