• Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
    CVS Health (07/23/25)
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  • Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in Eastern zones -BSN… more
    CVS Health (07/31/25)
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  • Utilization Management Nurse

    CenterWell (Harrisburg, PA)
    …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
    CenterWell (08/02/25)
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  • Clinical UM Nurse 2

    CenterWell (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... high-volume community or mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or Bachelor's degree in a… more
    CenterWell (08/01/25)
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  • Registered Nurse - Advanced Orthopedic…

    WellSpan Health (York, PA)
    …or neuro nursing required + Previous quality assessment and utilization management experience preferred **Licenses:** + Licensed Registered Nurse Upon Hire ... identifying areas that require attention. Is responsible for all program management , report generation and review, process improvement, patient satisfaction and… more
    WellSpan Health (08/01/25)
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  • Utilization Management Clinical…

    CVS Health (Harrisburg, PA)
    …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
    CVS Health (07/31/25)
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  • Case Management Nurse -RN Weekend…

    WellSpan Health (York, PA)
    …Required **Work Experience:** + 2 years Recent acute care experience. Required + Utilization management , case management , or clinical nursing specialty. ... **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine...Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered … more
    WellSpan Health (07/22/25)
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  • Registered Nurse - Case Manager - Day

    WellSpan Health (Lebanon, PA)
    …**Duties and Responsibilities** + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for continued ... quality and cost of care efforts. + Liaisons between utilization management team, third party payers, and...or Clinical Nursing Specialty. Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered Nurse more
    WellSpan Health (07/22/25)
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  • Disease Management Nurse - Remote

    Sharecare (Harrisburg, PA)
    …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
    Sharecare (07/12/25)
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  • Registered Nurse (RN)- Case…

    LifePoint Health (Johnstown, PA)
    …in employment. **Job:** **Nursing* **Organization:** ** **Title:** *Registered Nurse (RN)- Case Management PRN/Hourly* **Location:** *Pennsylvania-Johnstown* ... *Registered Nurse (RN), Case Manager PRN/Hourly* Job Type:PRN/Hourly| M-Sun...PRN/Hourly* Job Type:PRN/Hourly| M-Sun 8a-430p ** *Department/Unit Summary* Case Management plays an important role in the care of… more
    LifePoint Health (07/29/25)
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