- 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
- CVS Health (Harrisburg, PA)
- …and more compassionate. And we do it all with heart, each and every day. Utilization Management is a 24/7 operation and work schedule may include weekends, ... + 3+ years clinical practice experience as a Registered Nurse preferably in an acute setting (ex: OR, ER,...and unrestricted RN licensure in state of residence + Utilization Management is a 24/7 operation and… more
- CenterWell (Harrisburg, PA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- 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
- CVS Health (Harrisburg, PA)
- …experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult… more
- 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 Hire Required or + Registered … more
- 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 (Lebanon, PA)
- …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... year Clinical nursing experience. Required **Licenses:** + Licensed Practical Nurse Upon Hire Required or + Licensed Practical ...Nurse Upon Hire Required or + Licensed Practical Nurse Multi State License Upon Hire Required or +… more
- Veterans Affairs, Veterans Health Administration (Butler, PA)
- …of licensed vocational nurses/nursing assistants as appropriate to the setting. The nurse will assist in directing the provision of nursing education, orientation, ... competencies and providing quality improvement and outcomes utilization . Partners with the resident, family, and interdisciplinary team to promote effective and safe… more
- 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 ... regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the complex discharge… more
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