- Penn Medicine (Lancaster, PA)
- …Monday through Friday. RNs take turns starting at 8:00am so there is one RN available in the office until the others arrive at 8:30am. **POSITION SUMMARY:** ... physiologic, psychological, and cognitive functions, through patient/provider office visits, nurse visits, and telephone triage. Collaborates with Physician and… more
- UPMC (Pittsburgh, PA)
- …and proficiency in all aspects of member care, to include complex and/or specialized care. + Registered Nurse ( RN ) with an active PA License required + BSN ... assessments that include a clinical assessment and treatment, a review of the medical, functional, behavioral, pharmaceutical, and social...(BLS) OR Cardiopulmonary Resuscitation (CPR) + Driver's License + Registered Nurse ( RN ) + Act… more
- Guthrie (Sayre, PA)
- …or, a Bachelor of Arts (BA) degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to pursue a BSN or ... of hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who...in an acute care setting with strong care management, utilization review , and payer knowledge. A Case… more
- CenterWell (Lancaster, PA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- ChenMed (Philadelphia, PA)
- …RN with bachelor's degree in a related clinical field preferred + A valid, active Registered Nurse ( RN ) license in State of employment required + Compact ... the remaining hours. The Acute Care Manager, Complex Care ( RN ) is responsible for achieving positive patient outcomes, managing...patients' progress and adjust and plan accordingly + Understanding utilization review and how to leverage with… more
- Penn Medicine (Philadelphia, PA)
- …+ 5yrs prior experience as a Nurse Case Manager with knowledge of utilization review and 3rd Party Payors (Required) + Pennsylvania State Licensed Nurse ... each day. Are you living your life's work? Job Title: RN Pre Certification Case Manager Department: Business Operations -...a nurse case manager with knowledge of utilization review and third-party payors. We believe… more
- Evolent (Harrisburg, PA)
- …Registered Nurse + Associate or Bachelors in Nursing (Must be a Registered Nurse ) + Experience as an RN in a Pain MNGT setting is preferred. + Strong ... it. **What You'll Be Doing:** As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way… more
- Highmark Health (Monroeville, PA)
- …also building relationships across the organization in a community setting. **GENERAL OVERVIEW:** Registered nurse who is proficient in the coordination of care ... Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory… more
- LifePoint Health (Roaring Spring, PA)
- Conemaugh Nason Medical Center is seeking a part-time Registered Nurse for our Medical/Surgical Unit. The Staff Nurse has authority and accountability for ... making is based on his/her knowledge or skill level as determined by the Nurse Manager/Clinical Supervisor. The Staff Nurse will utilize the nursing process to… more
- Guthrie (Sayre, PA)
- …data analysis and process outcome evaluation. Education, License & Cert: Licensed Registered Nurse . Bachelor's Degree in Nursing or related field required. ... applicant must have a current license as a Professional Registered Nurse in their state of practice...in nursing practice. Preferred experience with PCMH process, care management/ utilization review , and payer knowledge. Fast paced… more