- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization Management ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific… more
- Guthrie (Sayre, PA)
- …approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of ... degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant...admissions and short procedures by translating clinical information to Utilization Management requirements using pre‐determined criteria. b.… more
- St. Luke's University Health Network (Quakertown, PA)
- …regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the complex ... the continuum of care. Also works with the providers, registered nurse care managers, social workers, and...limited to: RN care managers, assistants, coordinators, utilization management staff, and director. . Facilitates… more
- St. Luke's University Health Network (Orwigsburg, PA)
- …regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the complex ... the continuum of care. Also works with the providers, registered nurse care managers, social workers, and...limited to: RN care managers, assistants, coordinators, utilization management staff, and director. + Facilitates… more
- Geisinger (Danville, PA)
- …and efficiency results for assigned population. + Works to appropriately apply benefits and utilization management serving as a resource to the patient or member ... experience is required. The ideal candidate will have prior RN experience in a hospital setting. Case Management...Basic Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania… more
- Geisinger (Lewistown, PA)
- …and efficiency results for assigned population. + Works to appropriately apply benefits and utilization management serving as a resource to the patient or member ... of 2 years-Related work experience (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE… more
- Geisinger (Danville, PA)
- …(Required), Minimum of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; Advanced ... of experience to build a rewarding, lasting career with impact. Job Duties The RN Trauma Program Manager oversees personnel and daily operations related to the… 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 ... experience preferred. + 1 year of experience in clinical, utilization management , home care, discharge planning, and/or...(BLS) OR Cardiopulmonary Resuscitation (CPR) + Driver's License + Registered Nurse ( RN ) + Act… more
- Genesis Healthcare (Camp Hill, PA)
- …, ADON or ADON - Unit, or Director of Nursing ( Nurse Leader), the Registered Nurse ( RN ) delivers efficient and effective nursing care while achieving ... to achieve patient goals and minimize rehospitalizations; 4.4. Actively participates in Utilization Management or InterdisciplinaryCare Management Meeting to… more
- Fresenius Medical Center (Dallas, PA)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more