- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… 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 An ... R&E Nurse - Med Care Services- Advanced **Pay Rate** :...(MA), health care services, human services, long term care, utilization review, or knowledge of home care Knowledge of… more
- The Cigna Group (Philadelphia, PA)
- …Nursing + Three to Five (3-5) years recent experience in an acute-care environment, case- management or utilization management position (experience can be a ... provider practices + Identifies high-risk/high-cost patients for possible case management intervention. + Interfaces with providers of medical services and… more
- Marriott (Harrisburg, PA)
- …States **Schedule** Full-Time **Located Remotely?** Y **Relocation?** N **Position Type** Management **JOB SUMMARY** The Nurse CARE Manager coordinates timely, ... associates is a foremost concern in this position. **SCOPE** + Provides telephonic case management of associates with occupational illness/injuries to coordinate… more
- Evolent Health (Harrisburg, PA)
- …direct oversight of centralized telephonic review process of all necessary utilization management components. + Partner with leadership to mentor staff. ... culture. **What You'll Be Doing:** **Value Proposition Statement:** As a Director, Utilization Management , you'll work with your managers, front line clinical… more
- Gentiva (Harrisburg, PA)
- …coverage for the designated teams and functions as an interdisciplinary advanced illness management and support, along with telephonic , video, and in person ... practitioner, or PCP + Assist in overseeing the utilization of medications, DME and supplies related to the...patient confidentiality + Good problem-solving skills + Good time management skills **We Offer** **As a Registered Nurse… more
- Lancaster General Health (Lancaster, PA)
- … management platform/analytics. + Analyzes data to identify under/over utilization ; improve resource consumption; promotes potential reduction in cost and ... intensive follow-up. + Provide proactive outreach to patients to include telephonic , internet or face-to-face encounters. + Complete a comprehensive assessment of… more