• Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    RN licensure in state of residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical experience in acute or post-acute setting + ... in ER, Med/Surg, and/or Critical care setting + Managed Care experience + Utilization review experience + Experience working with MS office applications such… more
    CVS Health (08/08/25)
    - Related Jobs
  • Registered Nurse ( RN )- Case…

    LifePoint Health (Johnstown, PA)
    * Registered Nurse ( RN ), Case Manager...team of RN Case Managers, Social Workers, Utilization Review staff, and Discharge Planners assure that ... you're not just valued as an employee, but as a person. As a* registered nurse ( RN )*joining our team, you're embracing a vital mission dedicated to/making… more
    LifePoint Health (08/09/25)
    - Related Jobs
  • Case Manager Registered Nurse

    CVS Health (Harrisburg, PA)
    …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
    CVS Health (08/09/25)
    - Related Jobs
  • RN Pre Certification Case Manager

    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
    Penn Medicine (08/07/25)
    - Related Jobs
  • RN Acute Case Manager - Medical Social…

    Guthrie (Troy, 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
    Guthrie (08/08/25)
    - Related Jobs
  • RN Clinical Manager

    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
    CenterWell (06/17/25)
    - Related Jobs
  • Registered Nurse ( RN

    Penn Medicine (Lancaster, PA)
    …placement in position for incumbents who started after 07/01/2020. + A graduate registered nurse may only practice professional nursing under supervision and if ... the graduate registered nurse holds a current temporary practice... nurse is practicing. + All Clinical Nurse 1 RN 's will be required to… more
    Penn Medicine (08/07/25)
    - Related Jobs
  • Registered Nurse ( RN ) Spine…

    Penn Medicine (Lancaster, PA)
    …NCLEX within 60 days of starting in their RN role. + A graduate registered nurse may only practice professional nursing under supervision and if the graduate ... registered nurse holds a current temporary practice permit.... nurse is practicing. + All Clinical Nurse 1 RN 's will be required to successfully… more
    Penn Medicine (08/07/25)
    - Related Jobs
  • RN , Case Manager (Part time), Forbes

    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
    Highmark Health (05/13/25)
    - Related Jobs
  • Registered Nurse ( RN )DC-…

    Health Advocates Network (Selinsgrove, PA)
    Registered Nurse ( RN )DC- Short-Term **Pay Rate** : $58 / hour *W2 Minimum Qualifications Possession of a current license to practice as a registered ... nurses make assessments and decisions in regard to staff utilization and supplies and equipment needs. Charge nurse...is reviewed and evaluated by a Registered Nurse Supervisor, physician or dentist through observation, review more
    Health Advocates Network (07/31/25)
    - Related Jobs