- CVS Health (Harrisburg, PA)
- …And we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- Humana (Harrisburg, PA)
- …help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Cognizant (Harrisburg, PA)
- …. Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical … more
- Humana (Harrisburg, PA)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
- CVS Health (Harrisburg, PA)
- … (UM) Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all ... and state regulated turn-around times. This includes reviewing written clinical records. **Key Responsibilities of the UM Nurse...practice experience as an RN required. + 2+ Years Utilization Management experience. + Must be willing… more
- CVS Health (Harrisburg, PA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Harrisburg, PA)
- … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
- UPMC (Pittsburgh, PA)
- …1 year of health insurance experience preferred. + 1 year of experience in clinical , utilization management , home care, discharge planning, and/or case ... UPMC Your Care is Hiring a Full-Time Registered Nurse for a Nurse Clinical...and social history, current medications, geriatric syndromes, healthcare resource utilization , and case management interventions. Updates the… more
- Penn Medicine (Philadelphia, PA)
- …The Integrated Clinical Nurse Manager is responsible for assisting clinical and administrative leadership with the management of practice and operations ... life's work? Summary: + The role of the Integrated Clinical Nurse Manager is an integrated role...for staffing, regulatory compliance, employee performance management , clinical education and competency, capacity utilization , and… more
- WellSpan Health (York, PA)
- …a culture of quality, safety and efficient care. Assists the Director of Clinical Operations in management of staff to deliver high quality, patient-centered ... leadership and Medical Group practice experience. Required + Lean Daily Management experience. Preferred **Licenses:** + Licensed Registered Nurse Upon… more
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