• 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)
    …of Saturday shift is approximately 1 per month.** No travel is required. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... to make health care more personal, convenient and affordable. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote… more
    CVS Health (01/24/25)
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  • Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    …and work schedules may include weekends, holidays, and evening hours_ As a Utilization Management Nurse Consultant, you will utilize clinical skills ... **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current...of clinical experience in acute or post-acute setting + Utilization management is a 24/7 operation. Work… more
    CVS Health (01/24/25)
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  • RN - Registered Nurse

    Geisinger (Camp Hill, PA)
    …Experience Minimum of 1 year-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; Basic Life ... welcome applicants from the Harrisburg area to join Geisinger as an In-House Travel RN ! 12-week assignments are available in Adult Med Surg, Adult ICU, ED, OB, and… more
    Geisinger (11/17/24)
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  • Registered Nurse - Case…

    WellSpan Health (York, PA)
    Registered Nurse - Case Management - Day Location: WellSpan Health, York, PA Schedule: Part Time Schedule Part Time: 64 Hours/Biweekly Hours: 8:00am - 4:30pm ... Essential Functions: + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for..., or Clinical Nursing Specialty. Preferred Licenses: + Licensed Registered Nurse Upon Hire Required or +… more
    WellSpan Health (01/07/25)
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  • Registered Nurse

    UPMC (Harrisburg, PA)
    …+ Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Driver's License + Registered Nurse ( RN ) OR Temporary Practice Permit (TPP) + Act ... Registered Nurse , Home Health Harrisburg Are...plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians'… more
    UPMC (12/07/24)
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  • Utilization Management Clinician…

    CVS Health (Harrisburg, PA)
    …in the state of residence (LMSW, LCSW, LISW, LPC, or comparable) or Registered Nurse licensure with psychiatric specialty, certification, or experience in state ... EST. No weekends or holidays. - 1+ years of utilization review/ utilization management required ​...worker, MSW, LCSW, Behavioral /mental health services or if Registered Nurse , Associates degree required, BSN preferred… more
    CVS Health (01/25/25)
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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 Compliance Auditor

    Humana (Harrisburg, PA)
    …part of our caring community and help us put health first** The Compliance Nurse Auditor reviews utilization management activities and documentation to ... to prevent and detect fraud, waste, and abuse. The RN Compliance Nurse 2, Quality Assurance Audit...care, skilled and/or rehabilitation clinical setting + Experience with utilization management , pre-service denials and/or quality assurance… more
    Humana (01/23/25)
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  • RN Practice Site Manager- Heart & Vascular…

    Penn State Health (Camp Hill, PA)
    …+ Five (5) years of related experience required. + Currently licensed to practice as a Registered Nurse by state of employment or holds a multistate RN ... assistance._ **Position** RN Practice Site Manager- Heart & Vascular Cardiology **Location** US:PA: Camp Hill | Registered Nurse | Full Time **Req ID** 61834 more
    Penn State Health (01/07/25)
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  • Provider Transformation Specialist - ( RN

    Highmark Health (Harrisburg, PA)
    …adapt engagement strategies to meet market needs **LICENSES/CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + None **Language (Other than ... will require local travel.** This job is for an RN who will be directly responsible for outcomes of...greatest ROI for the Organization. Further, in a matrix management environment, will be responsible for collaborative work with… more
    Highmark Health (01/14/25)
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  • R&E Nurse - Med Care Services- Advanced

    Health Advocates Network (Harrisburg, PA)
    …hour *W2 Minimum Qualifications Possession of a current license to practice as a Registered Nurse issued by the Pennsylvania State Board of Nursing; or ... Nursing. Resources possessing non-renewable temporary practice permits must obtain licensure as a Registered Nurse within the one-year period as defined by the… more
    Health Advocates Network (11/16/24)
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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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  • Case Manager / PRN ( RN / RT / SW / LPN )

    Select Medical (Camp Hill, PA)
    … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,...**Current licensure in a clinical discipline either as a Nurse ( RN /LPN/ LVN)or a Respiratory Therapist… more
    Select Medical (12/06/24)
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  • Nurse Manager / Quality Coordinator

    Select Medical (Mechanicsburg, PA)
    …West Shore** A joint venture with Select Medical & UPMC Pinnacle Mechanicsburg, PA ** Nurse Manager / Quality Coordinator (Dual Role)** We are currently seeking a ... Nurse Manager/Quality Coordinator to join our collaborative leadership team....cost containment for areas of responsibility. + Maintaining effective utilization of manpower, equipment and supplies. + Assessing the… more
    Select Medical (01/17/25)
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  • Rehabilitation Manager- Senior Living

    BAYADA Home Health Care (Harrisburg, 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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  • Professional Care Manager Care Management

    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 (01/24/25)
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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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  • (Hybrid) Clinical Quality Value Analysis…

    Penn State Health (Hershey, PA)
    …required + Three (3) years of nursing experience + Currently licensed to practice as a registered nurse by state of employment or holds a multistate RN ... related to improved product, service and process standardization and utilization that either improves or maintains patient care. +...- Strategic Sourcing and Procurement **Location** US:PA: Hershey | Registered Nurse | Full Time **Req ID**… more
    Penn State Health (12/31/24)
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