• Mgr Utilization Review RN

    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
    Baylor Scott & White Health (01/23/25)
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  • 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)
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  • 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)
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  • 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 (01/17/25)
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  • 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)
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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...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
    Guardian Life (12/20/24)
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  • 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)
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  • Rehabilitation Manager- Senior Living

    BAYADA Home Health Care (Mechanicsburg, 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
    BAYADA Home Health Care (01/17/25)
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  • Sr. Professional Care Manager Outcomes…

    UPMC (Mechanicsburg, PA)
    …within 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
    UPMC (12/07/24)
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  • Professional Care Manager-Care Management

    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
    UPMC (12/07/24)
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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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  • Licensed Practical Nurse - MG Pediatrics…

    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 - MG Pediatrics - Market Street Location:...of patient care between visits. + Assists in the management of patient utilization of health care… more
    WellSpan Health (12/20/24)
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