• RN Utilization Management

    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
    Humana (01/07/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Clinician…

    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
    CVS Health (01/08/25)
    - Save Job - Related Jobs - Block Source
  • Manager of Case Management RN - Day

    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
    WellSpan Health (12/18/24)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse ( RN ), 4…

    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 (11/06/24)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse RN

    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 (12/07/24)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse ( RN ) 4L…

    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
    Lancaster General Health (10/30/24)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse RN

    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 (11/11/24)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse ( RN

    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
    Lancaster General Health (11/14/24)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse - Cardiac ICU…

    WellSpan Health (York, PA)
    Registered Nurse - Cardiac ICU -..., all components of advanced cardiac life support, pacemaker/ICD management , IABP management , CRRT utilization , ... Degree Nursing (BSN) Preferred Work Experience: + No experience. Required Licenses: + Licensed Registered Nurse Upon Hire Required or + Registered Nurse more
    WellSpan Health (11/23/24)
    - Save Job - Related Jobs - Block Source
  • Care Manager RN - Weekends (Remote)

    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
    Highmark Health (01/07/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Registered Nurse - Remote

    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
    Sharecare (01/08/25)
    - Save Job - Related Jobs - Block Source
  • Care Manager Behavioral Health - Part Time…

    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
    Highmark Health (12/12/24)
    - Save Job - Related Jobs - Block Source
  • R&E Nurse - Med Care Services- Advanced

    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
    Health Advocates Network (11/16/24)
    - Save Job - Related Jobs - Block Source
  • Physician Advisor

    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
    WellSpan Health (10/18/24)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Specialist…

    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
    Penn State Health (01/01/25)
    - Save Job - Related Jobs - Block Source
  • Care Nurse Coordinator RN - Extended…

    WellSpan Health (Mount Gretna, PA)
    RN III. Preferred and + Oncology nursing experience. Preferred Licenses: + Licensed Registered Nurse Upon Hire Required or + Registered Nurse ... Care Nurse Coordinator RN - Extended Acute...settings to provide appropriate care. + Coordinate with Case Management as indicated. + Participates in the review more
    WellSpan Health (11/26/24)
    - Save Job - Related Jobs - Block Source
  • Part-time Care Manager ( RN ) - Float (UPMC…

    UPMC (Harrisburg, PA)
    …with 4-6 weeks of hire. + UPMC approved Care Management certification preferred. + Registered Nurse ( RN ) + Act 31 Child Abuse Reporting with renewal + ... (CM) coordinates the clinical and financial plan for patients. Performs overall utilization management , resource management , discharge planning and… more
    UPMC (12/12/24)
    - Save Job - Related Jobs - Block Source
  • RN Clinical Consultant, Claims Shared…

    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
    Guardian Life (12/20/24)
    - Save Job - Related Jobs - Block Source
  • Epic Clinical ( RN ) Application Analyst…

    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
    Penn State Health (12/03/24)
    - Save Job - Related Jobs - Block Source
  • Registered Office Nurse ( RN

    Lancaster General Health (Lancaster, PA)
    …2 year commitment. Eligibility rules apply, including 15 months or greater RN experience. External applicants only. **POSITION SUMMARY:** Facilitates patient care in ... physiologic, psychological, and cognitive functions, through patient/provider office visits, nurse visits, and telephone triage. Collaborates with Physician and… more
    Lancaster General Health (12/03/24)
    - Save Job - Related Jobs - Block Source