• Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    …of time, talking on the telephone, and typing on the computer. The UM Nurse Consultant utilizes clinical skills to coordinate, document and communicate all ... aspects of the utilization /benefit management program. Applies critical thinking and knowledge in clinically appropriate treatment, evidence-based care and… more
    CVS Health (07/23/25)
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  • Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    …Must be willing and able to work Monday through Friday, 8:00am to 5:00pm. Utilization management is a 24/7 operation. Work schedules will include weekend/holiday ... zone + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required +...+ Managed Care experience + Discharge planning experience + Utilization Management experience **Education** Associates Degree or… more
    CVS Health (08/01/25)
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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 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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  • RN Director of Nursing - Allegheny General…

    Highmark Health (Pittsburgh, PA)
    …Oversees and ensures that standards of care are maintained relative to quality management , utilization review, and discharge planning. + Accountable to ensure ... an environment of transparency with the use of visual management boards on nursing units. + Promotes staff participation...Governance model in all departments. + Serves as a consultant for nurse managers and medical staff… more
    Highmark Health (07/25/25)
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  • DRG Specialist

    UPMC (Pittsburgh, PA)
    …documentation within the medical record to ensure that all patient resource utilization , principal diagnosis, secondary diagnoses, and PCS procedures have been coded ... to coding and compliance guidelines. + Meet with coding management as scheduled to review progress, discuss problems, and...System and DRG selection; OR specific knowledge as a consultant in Medical Record coding and DRG assignment required.… more
    UPMC (06/11/25)
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  • Director of Nursing

    Wellpath (Chester, PA)
    …the organization's Code of Conduct. + Demonstrates knowledge of risk management , clinical precautions, infection control, fall prevention, utilization of ... improvement activities,providesdirect supervision, and serves as a resource and consultant to nursing staff. + Monitorssafety issues,evaluateservicedeliveryand staff growth,… more
    Wellpath (07/23/25)
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