- Penn Medicine (Lancaster, PA)
- …placement in position for incumbents who started after 07/01/2020. + A graduate registered nurse may only practice professional nursing under supervision and if ... the graduate registered nurse holds a current temporary practice... nurse is practicing. + All Clinical Nurse 1 RN 's will be required to… 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 ... (0.8 FTE). Weekend, holiday rotation per department guidelines. The Lactation Support RN provides in-patient lactation consult services to mothers and babies at WBH… 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 ... demonstrates safe practice within the organizational professional practice model. The Clinical Nurse 2 Colleague possesses the knowledge, skills and the attitude to… more
- WellSpan Health (York, PA)
- Registered Nurse - Open Heart ICU - Night Location: York Hospital, York, PA Schedule: Full Time Schedule Full Time: 36 Hours/Week Hours: 7pm - 7am Every 3rd ... Preferred Work Experience: + Med/Surg or Critical Care experience preferred Licenses: + Licensed Registered Nurse Upon Hire Required or + Registered Nurse… more
- Highmark Health (Harrisburg, PA)
- …Highmark Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of ... + Experience in UM/CM/QA/Managed Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse ( RN ) license + Delaware RN … more
- WellSpan Health (York, PA)
- …experience. Required + Lean Daily Management experience. Preferred Licenses: + Licensed Registered Nurse Upon Hire Required or + Registered Nurse ... Manager Clinical Operations - Registered Nurse - Heart & Vascular...efficient care. Assists the Director of Clinical Operations in management of staff to deliver high quality, patient-centered care.… more
- Humana (Harrisburg, PA)
- …guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse ( RN ) in the state of Virginia or ... licensure + Previous Medicare/Medicaid experience a plus + Previous experience in utilization management , case management , discharge planning and/or home… 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
- WellSpan Health (York, PA)
- …York, PA Schedule: Full Time 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
- Humana (Harrisburg, PA)
- …part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments… more
- Humana (Harrisburg, PA)
- …of our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to ... of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific guidelines… more
- Highmark Health (Harrisburg, PA)
- …advisor and third party payers. + Maintains a working knowledge of care management , care coordination changes, utilization review changes, authorization ... planning and community resource knowledge + Care facilitation and utilization review experience **LICENSES or CERTIFICATIONS** **Required** + RN license In… more
- WellSpan Health (Lebanon, 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
- Evolent (Harrisburg, PA)
- …+ Performs other duties as assigned. **Qualifications: Required and Preferred:** + Licensed registered nurse or LVN/LPN (current and unrestricted) + Minimum of ... refers quality issues to the Senior Director of Medical Management or Medical Director. + Appropriately identifies potential cases...patient care + **Minimum one year of experience with Utilization Review (UM) in a managed care… 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
- Sedgwick (Harrisburg, PA)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Medicare Compliance **We are growing and looking for nurses who have their ... clinical data; to complete complex submissions revisions/updates in preparation for Medicare review and act as an internal resource regarding Centers for Medicare &… more
- Penn Medicine (Lancaster, PA)
- …: Full-Time, Day Shift, 40 hours/week. Monday through Friday 8:00am-4:30pm. Every 6th week, each nurse takes a turn and will rotate to a "late week" and work from ... physiologic, psychological, and cognitive functions, through patient/provider office visits, nurse visits, and telephone triage. Collaborates with Physician and… more
- Penn Medicine (Lancaster, PA)
- …physiologic, psychological, and cognitive functions, through patient/provider office visits, nurse visits, and telephone triage. Collaborates with Physician and ... physiologic, psychological, and cognitive functions, through patient/provider office visits, nurse visits, and telephone triage. Collects and manages comprehensive… more
- UPMC (Mechanicsburg, 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 (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 - Pediatrics Queen Street & Dover Location:...of patient care between visits. + Assists in the management of patient utilization of health care… more