• 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 ... 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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  • Utilization Management Nurse

    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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (10/18/25)
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  • SNF Utilization Management RN…

    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 ... 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)
    …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... 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 Appeals and… more
    Cognizant (10/07/25)
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  • Consultant, Nurse Disability I

    Lincoln Financial (Harrisburg, PA)
    …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
    Lincoln Financial (10/10/25)
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  • Utilization Review Clinician - ABA

    Centene Corporation (Harrisburg, PA)
    …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
    Centene Corporation (10/19/25)
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  • Care Management Nurse - Nights

    WellSpan Health (York, PA)
    …- day shift_** **General Summary** Performs a variety of duties and applies utilization and care management techniques to determine the most efficient use ... address patient care transition needs. Provides leadership in the integration of utilization and care management principles throughout the hospital. **Duties and… more
    WellSpan Health (10/17/25)
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  • Registered Nurse - Case Manager - PRN

    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 (10/15/25)
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  • Cost Containment Analyst

    ICW Group (Philadelphia, PA)
    …AND SKILLS** Understanding of Workers' Compensation, Workers' Compensation Managed Care processes, Utilization Review, Telephonic Nurse Case Management , and ... **ESSENTIAL DUTIES AND RESPONSIBILITIES** Provides oversight for all vended Nurse Case Management (NCM) products, including Field... management issues related to bill review, case management and utilization review. + Works closely… more
    ICW Group (09/22/25)
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  • Registered Nurse Supervisor (2nd Shift)…

    Commonwealth of Pennsylvania (PA)
    Registered Nurse Supervisor (2nd Shift) - Selinsgrove Center Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5095157) Apply  Registered ... Nurse Supervisor (2nd Shift) - Selinsgrove Center Salary $96,225.00...City Selinsgrove, Pennsylvania Zip Code 17870 Contact Name Talent Management Division Contact Email ###@pa.gov + Description + Benefits… more
    Commonwealth of Pennsylvania (10/13/25)
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