- CVS Health (Harrisburg, PA)
- …we do it all with heart, each and every day. Position Summary The Utilization Management Clinical Nurse Consultant utilizes clinical skills to coordinate, ... Arizona Time Zone. Preferred Qualifications : Previous experience with utilization management . Previous clinical experience in Emergency Department,… more
- CVS Health (Harrisburg, PA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. UMNC meets set productivity and quality ... Holidayand late rotations. Required Qualifications 3+ years of experience as a Registered Nurse Must have active current and unrestricted RN licensure in state of… more
- AmeriHealth Caritas (Newtown Square, PA)
- Role Overview Under the direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity for inpatient and outpatient services, ... making determinations based on clinical criteria. Using professional judgment, the Utilization Management Reviewer assesses the appropriateness of services,… more
- AmeriHealth Caritas (Newtown Square, PA)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... timely engagement of case management of all transplant members. Conduct utilization management reviews for all transplant services by assessing medical… more
- AmeriHealth Caritas (Newtown Square, PA)
- …with providers and appropriate others to facilitate and coordinate the Utilization Management process(es) activities. Utilize technology and resources (systems, ... it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other… more
- Select Medical (Hummelstown, PA)
- …venture with Select Medical & Penn State Health Director of Quality Management (DQM) Bonus incentives Extensive onboarding and training program Customizable health ... amputation, and multiple traumas Responsibilities Coordinates the Medical Quality Management and Performance Improvement activities to measurably enhance the… more
- Amgen (Scranton, PA)
- …playing a key role in establishing product demand and delivering comprehensive account management within a designated territory. You will serve a central point of ... support optimal patient care. As an Account Manager, you will drive product utilization while identifying and addressing the unique needs of each account. This… more
- WellSpan Health (Chambersburg, PA)
- …effectively manager cost and maximize employee satisfaction and resource utilization . Duties and Responsibilities Essential Functions: Facilitates and directs ... Creates customized reports to present data valuable to logistics manager, nurse managers, department directors, and finance partners for resource management… more
- Penn Medicine (Lancaster, PA)
- …physician, nurse and patient regarding the contents, therapeutic action, utilization and possible adverse reactions or interactions of medication. Responds to ... improve patient outcomes and reduce costs. Utilizes assessment skills in the management of medically complex elderly to monitor responses to drug therapy. Provides… more
- Geisinger (Danville, PA)
- …weekend shifts! Also offering up to $40,000 in financial support to become a nurse ! Job Duties Benefits of working at Geisinger Full benefits (health, dental and ... maintaining proper hygiene of equipment on each unit. Assists nurse educators with staff education and training in use...assumes role of mentor to nursing staff for the utilization of all available lifting equipment in an appropriate… more
- GE Aerospace (Feasterville Trevose, PA)
- …does not directly own infrastructure platforms. The role accelerates digital utilization by standardizing data models, establishing reusable patterns, ensuring high ... data models, semantic layers, and reusable transformation patterns. Data Management and Governance Implement data governance with domain-aligned stewardship,… more
- Community Health Systems (Wilkes Barre, PA)
- …census, coordinates admissions, discharges, and transfers, and ensures optimal bed utilization . Acts as the administrative point of contact for staff, patients, ... all policies and standards. Leadership Responsibilities Supervision and Staff Management Supervises, trains and oversees departmental staff. Schedules employees to… more
- Penn Medicine (Lancaster, PA)
- …clinical information with emergency department clinical staff Emergency Department Charge Nurse . Receive Medical command calls and ensure timely connection with ... responders if internal incident exceeds internal capabilities, collaboration with emergency management team at LGH and or with Incident command structure when… more
- CVS Health (Harrisburg, PA)
- …1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have active ... Nursing Licenses as business needs require. * **Preferred Qualifications** - Utilization Management experience preferred **Education** Associates Degree BSN… more
- CVS Health (Harrisburg, PA)
- …1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience Must have active current ... additional Nursing Licenses as business needs require. * Preferred Qualifications - Utilization Management experience preferred - **Anticipated Weekly Hours** 40… more
- CVS Health (Harrisburg, PA)
- …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, ... Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must...and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and… more
- CVS Health (Harrisburg, PA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... late rotations. **Required Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN licensure in state of… more
- CVS Health (Harrisburg, PA)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal...Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN… more
- CenterWell (Harrisburg, PA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- 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
