- 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 (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 (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 (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
- 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
- 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
- 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
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