- Commonwealth of Pennsylvania (PA)
- …I have professional experience performing this Work Behavior as a charge nurse , head nurse , utilization review nurse , quality assurance nurse , or ... I have experience performing this Work Behavior as a charge nurse , head nurse , utilization review nurse , quality assurance nurse , or an… more
- Penn State Health (Hershey, PA)
- …or genetic information._ **Union:** SEIU Healthcare Pennsylvania **Position** RN Registered Nurse Utilization Management Specialist - Utilization Management ... at ###@pennstatehealth.psu.edu (MAILTO://###@pennstatehealth.psu.edu) **SUMMARY OF POSITION:** Responsible for the review of clinical documentation in the Electronic Medical Record… more
- CenterWell (Harrisburg, PA)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to… more
- Centene Corporation (Harrisburg, PA)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... shifts, or 5-8HR shifts. **Position Purpose:** Performs a clinical review and assesses care related to mental health and...Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members… more
- Penn Medicine (Philadelphia, PA)
- …or Equivalent Experience: + Bachelor of Arts or Science (Required) + Utilization Review experience (Required) + Bachelor's Degree in Nursing required.2+ ... quality data collection and risk management referral. Responsibilities: + Utilization management activities: monitor appropriate use of internal resources,… more
- UPMC (Pittsburgh, PA)
- **UPMC Your Care is Hiring a Full-Time Registered Nurse for a Nurse Clinical Care Coordinator Position.** **Monday-Thursday 9:30am-8:00pm** **This position ... travels to patients' homes in Allegheny County.** The Nurse Clinical Care Coordinator is responsible for delivering nursing assessments and evaluations within… more
- Evolent (Harrisburg, PA)
- …a mission with a company behind it. **What You'll Be Doing:** As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can ... better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer, Nurse , you will routinely interact with leadership and management...You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not… more
- Evolent (Harrisburg, PA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We ... better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer, Nurse , you will routinely interact with leadership and management...You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not… more
- Penn Medicine (Lancaster, PA)
- …as defined by the American Nurses Association standards of nursing practice. The Clinical Nurse 1 New to Practice/Apprentice is a newly licensed new to practice RN ... safe practice within the organizational professional practice model. The Clinical Nurse 1 New to Practice/Apprentice seeks guidance to integrate concepts, knowledge,… more
- Health Advocates Network (Camp Hill, PA)
- …shift. Charge nurses make assessments and decisions in regard to staff utilization and supplies and equipment needs. Charge nurse supervises paraprofessional ... of professional nursing practices. Work is reviewed and evaluated by a Registered Nurse Supervisor, physician or dentist through observation, review of reports… more