- Humana (Harrisburg, PA)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Harrisburg, PA)
- …1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have active ... Nursing Licenses as business needs require. * **Preferred Qualifications** - Utilization Management experience preferred **Education** Associates Degree BSN… more
- CVS Health (Harrisburg, PA)
- …1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience Must have active current ... additional Nursing Licenses as business needs require. * Preferred Qualifications - Utilization Management experience preferred - **Anticipated Weekly Hours** 40… more
- CVS Health (Harrisburg, PA)
- …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, ... Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must...and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and… more
- CVS Health (Harrisburg, PA)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal...Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN… more
- CenterWell (Harrisburg, PA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- CVS Health (Harrisburg, PA)
- …all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit ... solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other… more
- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Highmark Health (Harrisburg, PA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... setting **Preferred** + Experience in UM/CM/QA/Managed Care + Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience… more
- WellSpan Health (York, PA)
- …**Essential Functions:** + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for continued ... quality and cost of care efforts. + Liaisons between utilization management team, third party payers, and...or Clinical Nursing Specialty. Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered Nurse… more
- WellSpan Health (Lebanon, PA)
- …**Duties and Responsibilities** + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for continued ... quality and cost of care efforts. + Liaisons between utilization management team, third party payers, and...or Clinical Nursing Specialty. Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered Nurse… more
- WellSpan Health (Lebanon, PA)
- …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... year Clinical nursing experience. Required **Licenses:** + Licensed Practical Nurse Upon Hire Required or + Licensed Practical ...Nurse Upon Hire Required or + Licensed Practical Nurse Multi State License Upon Hire Required or +… more
- Veterans Affairs, Veterans Health Administration (Perry Point, MD)
- …promotion, health education and coaching on wellness, disease prevention, and chronic care management . The nurse will assist in directing the provision of ... care. Responsibilities The Patient Aligned Care Team (PACT) Outpatient Staff Registered Nurse (RN) is responsible for providing competent primary care to patients… more
- Penn Medicine (Lancaster, PA)
- …holidays, no call. Summary: + Position Summary: + Under the direction of the Nurse Manager, the Assistant Nurse Manager assesses, plans, implements and evaluates ... to the primary duties listed above: + In collaboration with the Nurse Manager, counsels employees and takes appropriate disciplinary action for infractions of… more
- Penn Medicine (Lancaster, PA)
- …as defined by the American Nurses Association standards of nursing practice. The Clinical Nurse 1 New to Practice/Apprentice is a newly licensed new to practice RN ... safe practice within the organizational professional practice model. The Clinical Nurse 1 New to Practice/Apprentice seeks guidance to integrate concepts, knowledge,… more
- Penn Medicine (Lancaster, PA)
- …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 on the ... demonstrates safe practice within the organizational professional practice model. The Clinical Nurse 2 Colleague possesses the knowledge, skills and the attitude to… more
- Penn Medicine (Lancaster, PA)
- …Level I-accredited Trauma Center. **Position Summary:** + Under the direction of the Nurse Manager, the Assistant Nurse Manager assesses, plans, implements and ... to the primary duties listed above: + In collaboration with the Nurse Manager, counsels' employees and takes appropriate disciplinary action for infractions of… more
- Penn Medicine (Lancaster, PA)
- …condition can change quickly. **Position Summary:** + Under the direction of the Nurse Manager, the Assistant Nurse Manager assesses, plans, implements and ... to the primary duties listed above: + In collaboration with the Nurse Manager, counsels employees and takes appropriate disciplinary action for infractions of… more
- Highmark Health (Harrisburg, PA)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) or WV or DE or...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
- WellSpan Health (Ephrata, PA)
- …the established plan of care, corporate policy and procedures, and the Nurse Practice Act. **Duties and Responsibilities** **Essential Functions:** + Participates in ... the plan of care and assigned by the primary nurse . + Notifies physician and other care agencies of...climate of mutual respect and teamwork among co-workers and management . + Assist in the orientation of new staff.… more