- CVS Health (Harrisburg, PA)
- …do it all with heart, each and every day. **Position Summary** Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, ... rounds * Assists with escalated case reviews/facility issues * Gathers clinical information and applies the appropriate clinical criteria/guideline, policy,… more
- CVS Health (Harrisburg, PA)
- …heart, each and every day. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. Utilization management ... to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal...residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical experience… more
- CVS Health (Harrisburg, PA)
- …work schedules will include weekends, holidays, and evening hours._ + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, ... to facilitate appropriate healthcare services/benefits for members. + Gathers clinical information and applies the appropriate clinical criteria/guideline,… more
- Lincoln Financial (Harrisburg, PA)
- …74628 **The Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be ... and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills… more
- Highmark Health (Harrisburg, PA)
- …Facing support **SKILLS** + Deep Clincal Expertise -extensive knowledge of clinical , quality, care, utilization , high-cost claim, and population health ... or Clinical field **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse (RN) or Pharmacist (Pharm D) or Physician Assistant (PA) **Preferred** +… more
- ChenMed (Philadelphia, PA)
- …+ The Nurse Practitioner (NP) acts as part of the clinical operations team and is responsible for providing direct patient care in ChenMed/Jencare ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...may require participation in risk and quality management programs, clinical meetings and other meetings.The Nurse Practitioner… more
- UPMC (Pittsburgh, PA)
- …role requires three years of coding experience. In this role, you will review clinical documentation within the medical record to ensure that all patient resource ... utilization , principal diagnosis, secondary diagnoses, and PCS procedures have...requested. + Formulate physician queries that present indications, utilizing clinical judgment, of a diagnosis that is not clearly… more
- Wellpath (Chester, PA)
- …the organization's Code of Conduct. + Demonstrates knowledge of risk management, clinical precautions, infection control, fall prevention, utilization of special ... month over month and a very large percent of those individuals receive direct clinical care, which includes lives saved by Narcan. We offer ongoing training and… more
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