• Utilization Nurse Consultant

    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 (05/22/25)
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  • Utilization Management Nurse

    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 (05/15/25)
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  • Utilization Management Nurse

    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
    CVS Health (05/24/25)
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  • Consultant , Nurse Disability

    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
    Lincoln Financial (05/22/25)
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  • Senior Clinical Strategy Consultant

    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
    Highmark Health (05/10/25)
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  • Nurse Practitioner

    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
    ChenMed (05/10/25)
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  • DRG Specialist

    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
    UPMC (05/21/25)
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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 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
    Wellpath (05/21/25)
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