• Utilization Management

    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
    CVS Health (10/26/25)
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  • Utilization Management Nurse

    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
    Humana (09/12/25)
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  • Clinical Registered Nurse

    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
    Cognizant (10/07/25)
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  • SNF Utilization Management RN…

    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
    Humana (09/12/25)
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  • Utilization Management Nurse

    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 (10/25/25)
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  • Utilization Management

    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 (10/26/25)
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  • Utilization Management Clinician-…

    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
    CVS Health (10/21/25)
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  • Weekend Nurse Clinical Care Coord…

    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
    UPMC (10/11/25)
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  • Clinical Nurse Manager Oncology…

    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
    Penn Medicine (09/30/25)
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  • Manager Clinical Operations Registered…

    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
    WellSpan Health (10/08/25)
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