- Humana (Harrisburg, PA)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) with no… 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
- 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
- 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
- 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
- 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
- Intermountain Health (Harrisburg, PA)
- …REGISTRATION, LICENSE (*indicates primary source verification requirement) Required: + Active Registered Nurse License Preferred: + Certified Healthcare Access ... Associate (CHAA) EXPERIENCE Required: + Licensed Registered Nurse + Minimum of 2 years'...experience in acute clinical nursing setting + Knowledge of utilization management and case management … more
- Guardian Life (Harrisburg, PA)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
- Penn State Health (Hershey, PA)
- …Transfer Center support, Capacity Command Center reporting, and predictive utilization analytics. **Cadence Enterprise Scheduling** makes it easy for users ... tools that help improve patient services and maximize staff and resource utilization . MyChart integration allows patients to schedule their own appointments, which… more
- BAYADA Home Health Care (Harrisburg, PA)
- …Health Care** is seeking a full-time **Physical Therapist (PT), Occupational Therapist (OT), or Registered Nurse ( RN )** to fill the position of **Rehab ... + Current license in good standing, Physical Therapist (PT), Occupational Therapist (OT), or Registered Nurse ( RN ) + Prior supervisory experience + Minimum… more
- UPMC (Harrisburg, PA)
- …with 4-6 weeks of hire. UPMC approved Care Management certification preferred. + Registered Nurse ( RN ) *Current licensure either in the state where the ... (CM) coordinates the clinical and financial plan for patients. Performs overall utilization management , resource management , discharge planning and… more
- WellSpan Health (Lebanon, PA)
- …or + Licensed Practical Nurse Multi State License Upon Hire Required or + Licensed Registered Nurse Upon Hire Required or + Registered Nurse Multi ... Licensed Practical Nurse - Outpatient Orthopedics Lebanon - Days Location:...of patient care between visits. + Assists in the management of patient utilization of health care… more