• Utilization Management Nurse

    Humana (Harrisburg, PA)
    …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a… more
    Humana (09/12/25)
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  • Utilization Management Clinical…

    CVS Health (Harrisburg, PA)
    …+ Active and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC ... working within the mental health system . + Previous experience with utilization management . + Ability to collaborate with various internal departments. +… more
    CVS Health (11/06/25)
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  • Utilization Management Appeals…

    Humana (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
    Humana (11/12/25)
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  • RN Utilization Management

    Guthrie (Sayre, PA)
    Up To $25,000 Sign On Bonus For Qualified RNs! Summary The Registered Nurse ( RN ) Utilization Management (UM) in collaboration with Care Coordination, ... coding, medical record or chart auditing, and experience in utilization management processes preferred. Knowledge of computer...of patient status. + Collaborate and set standards with registered nurse ( RN ) case managers… more
    Guthrie (11/11/25)
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  • Registered Nurse - Case…

    WellSpan Health (Waynesboro, PA)
    …Required **Work Experience:** + 2 years Recent acute care experience. Required + Utilization management , care management , or clinical nursing specialty. ... **General Summary** Performs a variety of duties and applies utilization and care management techniques to determine...Preferred **Licenses:** + Licensed Registered Nurse Upon… more
    WellSpan Health (11/05/25)
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  • RN Acute Case Manager - System Care…

    Guthrie (Sayre, PA)
    …recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care in collaboration with ... 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
    Guthrie (10/15/25)
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  • Inpatient Social Worker (MSW) or Registered

    St. Luke's University Health Network (Stroudsburg, PA)
    …including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director. . Facilitates communication among all ... we serve, regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the… more
    St. Luke's University Health Network (11/03/25)
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  • Inpatient Social Worker (MSW) or Registered

    St. Luke's University Health Network (Bethlehem, PA)
    …including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director. + Facilitates communication among all ... we serve, regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the… more
    St. Luke's University Health Network (10/15/25)
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  • RN - Registered Nurse

    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 (09/28/25)
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  • RN - Registered Nurse

    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 (11/05/25)
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