• Inpatient Case Manager RN or Social Worker…

    Penn Medicine (Lancaster, PA)
    …requirements being one of the following: + RN : Current licensure as a Registered Nurse , issued by the Pennsylvania Board of Nursing. Bachelor's degree in ... + Other duties as assigned. **Minimum Required Qualifications:** + RN , Masters in Health related field or Social Worker...Bachelor's degree in Nursing BSN . + Knowledge of utilization review or managed care. + Care… more
    Penn Medicine (08/07/25)
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  • Registered Nurse - Surgical ICU…

    WellSpan Health (York, PA)
    …Care experience preferred + 1 year of RN experience required **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered Nurse Multi ... (acute and chronic), external pacer and temporary pacer, CRRT utilization , EKOS catheter-directed and ultrasound thrombolysis. **Department Summary** Surgical… more
    WellSpan Health (07/15/25)
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  • Registered Nurse - Cardiac ICU…

    WellSpan Health (York, PA)
    …Preferred **Work Experience:** + 1 year of RN experience required **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered Nurse ... of advanced cardiac life support, pacemaker/ICD management, IABP management, CRRT utilization , and Impella. **General Summary** Provides professional nursing care in… more
    WellSpan Health (07/14/25)
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  • Registered Nurse - Open Heart ICU…

    WellSpan Health (York, PA)
    …Preferred **Work Experience:** + Med/Surg or Critical Care experience preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered ... advanced cardiac life support, pacemaker/ICD management, IABP management, CRRT utilization , ventricular assist device (VAD) management, and ECMO. **General Summary**… more
    WellSpan Health (07/10/25)
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  • RN Case Manager Emergency, Allegheny…

    Highmark Health (Pittsburgh, PA)
    …with operational areas regarding issues related to supported technology. Manage utilization review , translation of foreign claims, coordination of benefits ... benefits/requirements/limits, discharge planning requirements, length of stay and resource utilization issues. + Adheres to the policies, procedures, rules,… more
    Highmark Health (06/14/25)
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  • Registered Nurse - Advanced…

    WellSpan Health (York, PA)
    …Previous quality assessment and utilization management experience preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered ... attention. Is responsible for all program management, report generation and review , process improvement, patient satisfaction and administrative activities of the… more
    WellSpan Health (08/01/25)
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  • RN Care Coordinator PCMH (Patient Centered…

    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
    Guthrie (08/12/25)
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  • Appeals Registered Nurse

    Evolent (Harrisburg, PA)
    …focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and procedures ... work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators...Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more
    Evolent (08/08/25)
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  • Clinical Resource Coordinator

    Penn Medicine (Philadelphia, PA)
    …assignment (Outlook, Canopy, CERME, ECIN, shared drive, Internet) Credentials: + Registered Nurse - PA (Required) + PA RN Licensure required. Education or ... **The candidate for this position must be a seasoned med/surg nurse with a minimum of 5 years' experience in Utilization review and 3 years of experience in… more
    Penn Medicine (08/07/25)
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  • RN Care Coordinator Transitional Care…

    Guthrie (Sayre, PA)
    …leadership and autonomy in nursing practice. Preferred experience with care management/ utilization review , and payer knowledge. Fast paced ambulatory care ... and Pennsylvania. The applicant must have a current license as a Professional Registered Nurse in their state of practice prior to the position's start date.… more
    Guthrie (07/18/25)
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