• Utilization Management Nurse

    WellSpan Health (York, PA)
    Utilization Management Nurse ( RN ) -...administration or management . Preferred Licenses: + Licensed Registered Nurse Upon Hire Required or + ... quality health care. Provides leadership in the integration of utilization management principles throughout the System. Responsible... Registered Nurse Multi State License Upon Hire Required Apply Now… more
    WellSpan Health (01/24/25)
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  • Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    …Friday 8:00 am to 5:00 pm CST with rotating late evening and weekend shifts. Utilization Management is a 24/7 operation and work schedule may include weekends, ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + Must reside in… more
    CVS Health (01/22/25)
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  • Care Manager RN - Weekends ( Remote

    Highmark Health (Harrisburg, PA)
    …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
    Highmark Health (01/07/25)
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  • 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...plan and length of disability. Plan for ongoing case management through proactive partnering with treating providers to move… more
    Guardian Life (12/20/24)
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  • Licensed Practical Nurse - Internal…

    WellSpan Health (York, 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 - Internal Medicine Apple Hill York Location:...of patient care between visits. + Assists in the management of patient utilization of health care… more
    WellSpan Health (01/12/25)
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  • Senior Process Improvement Professional

    Humana (Harrisburg, PA)
    …your skills to make an impact** **Required Qualifications** + Associate degree + Active Registered Nurse , ( RN ), License in your state of residence without ... project management and/or process improvement experience + Minimum 3 years utilization management experience with exposure to grievance and appeals +… more
    Humana (01/23/25)
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