- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Baylor Scott & White Health (Harrisburg, PA)
- …and members. **Key Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels. + ... type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- Highmark Health (Harrisburg, PA)
- …third party payers, etc. (30%) + Maintains a working knowledge of care management , utilization review changes, authorization changes, contract changes, ... as an educational resource to all AHN staff regarding utilization review practice and governmental/commercial payer guidelines.(5%)...of bachelor's degree + Current PA licensure as a RN + Nationally recognized Care Management Certification… more
- CVS Health (Harrisburg, PA)
- …through Friday 8:30-5pm EST. No weekends or holidays. - 1+ years of utilization review / utilization management required **Preferred Qualifications** ... in the state of residence (LMSW, LCSW, LISW, LPC, or comparable) or Registered Nurse licensure with psychiatric specialty, certification, or experience in state… more
- WellSpan Health (Lebanon, PA)
- …and resolve barriers for staff. Common Expectations: + Demonstrates knowledge of case management , utilization review and population health. Assesses and ... Manager of Case Management RN - Day Location: WellSpan...staff on issues involving discharge planning, payer relations and utilization review . + Monitors and shares department… more
- Lancaster General Health (Lancaster, PA)
- …NCLEX within 60 days of starting in their RN role. + A graduate registered nurse may only practice professional nursing under supervision and if the graduate ... American Nurses Association standards of nursing practice. The Clinical Nurse 2 Colleague is an RN that... registered nurse holds a current temporary practice… more
- Lancaster General Health (Lancaster, PA)
- **Summary** We are seeking a Registered Nurse to join the Observation... nurse is practicing. + All Clinical Nurse 1 RN 's will be required to ... to Practice/Apprentice is a newly licensed new to practice RN or RN with less than 15...for incumbents who started after 07/01/2020. + A graduate registered nurse may only practice professional nursing… more
- Lancaster General Health (Lancaster, PA)
- …NCLEX within 60 days of starting in their RN role. + A graduate registered nurse may only practice professional nursing under supervision and if the graduate ... that established outcomes are achieved through availability and appropriated utilization of human, material and financial resources. + Educates...area or unit where the graduate registered nurse is practicing. + For Magnet designated RN… more
- Health Advocates Network (Selinsgrove, PA)
- Registered Nurse ( RN )DC- Short-Term **Pay Rate:** $62 / hour *W2 Minimum Qualifications Possession of a current license to practice as a registered ... nurses make assessments and decisions in regard to staff utilization and supplies and equipment needs. Charge nurse...is reviewed and evaluated by a Registered Nurse Supervisor, physician or dentist through observation, review… more
- Lancaster General Health (Lancaster, PA)
- **Summary** We are seeking an experienced, dedicated and proactive Centralized Monitoring Registered Nurse ( RN ) to join our dynamic team. In this pivotal ... as defined by the American Nurses Association standards of nursing practice. The Clinical Nurse 2 Colleague is an RN that practices as a full partner… more
- Lancaster General Health (Lancaster, PA)
- …staffing needs. Required to work 1 holiday per year. **1 year of Registered Nurse NICU experience is required.** **POSITION SUMMARY:** Assume responsibility and ... as defined by the American Nurses Association standards of nursing practice. The Clinical Nurse 2 Colleague is an RN that practices as a full partner… more
- WellSpan Health (York, PA)
- Registered Nurse - Open Heart ICU - Night Location: York Hospital, York, PA Schedule: Full Time Schedule Full Time: 36 Hours/Week Hours: 7pm - 7am Every 3rd ... Preferred Work Experience: + Med/Surg or Critical Care experience preferred Licenses: + Licensed Registered Nurse Upon Hire Required or + Registered Nurse… more
- WellSpan Health (York, PA)
- Registered Nurse - Medical ICU - Nights Location: York Hospital, York, PA Schedule: Full Time Schedule Full Time: 72 Hours/Biweekly Hours: 7:00pm - 7:00am Every ... Degree Nursing (BSN) Preferred Work Experience: + No experience. Required Licenses: + Licensed Registered Nurse Upon Hire Required or + Registered Nurse… more
- Highmark Health (Harrisburg, PA)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Sharecare (Harrisburg, PA)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- Highmark Health (Harrisburg, PA)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- Health Advocates Network (Harrisburg, PA)
- …setting, behavioral health setting, drug and alcohol setting, managed care, quality management / utilization review or other related clinical experience; or ... Possession of a current license to practice as a Registered Nurse issued by the Pennsylvania State...(MA), health care services, human services, long term care, utilization review , or knowledge of home care… more
- WellSpan Health (York, PA)
- …York, PA Schedule: PRN/Per Diem General Summary Provides direct supervision of case management and utilization review activities performed by the WellSpan ... staff. Duties and Responsibilities Essential Functions: + Renders utilization management determination in accordance with State...of care and verify need for peer to peer review -discuss with the CM nurse and/or attending… more
- CVS Health (Harrisburg, PA)
- …more personal, convenient and affordable. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. Utilization ... of residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical...and/or Critical care setting + Managed Care experience + Utilization review experience + Experience working with… more
- Penn State Health (Hershey, PA)
- …for maintaining compliance with the CMS Conditions of Participation for Utilization Management . **MINIMUM QUALIFICATIONS:** + Bachelors Degree in Nursing ... setting required. + Currently licensed to practice as a Registered Nurse by state of employment or...medical or genetic information._ **Union:** SEIU Healthcare Pennsylvania **Position** Utilization Management Specialist - DAY SHIFT -… more