• Utilization Management Nurse

    Humana (Harrisburg, PA)
    …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
    Humana (09/12/25)
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  • Utilization Management Nurse

    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 (12/09/25)
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  • Utilization Management Nurse

    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 (12/09/25)
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  • Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... telephone and typing on the computer. + Work from home position:During work hours, Colleagues who are working from...Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN… more
    CVS Health (12/09/25)
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  • Utilization Management Nurse

    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
    CenterWell (11/22/25)
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  • SNF Utilization Management RN…

    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
    Humana (09/12/25)
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  • Utilization Review Clinician - ABA

    Centene Corporation (Harrisburg, PA)
    …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... a fresh perspective on workplace flexibility. **THIS POSITION IS REMOTE/WORK FROM HOME SUPPORTING PENNSYLVANIA HEALTH & WELLNESS MEDICAID CHIP PROGRAM.** **THE WORK… more
    Centene Corporation (12/05/25)
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  • Registered Nurse - Case Management

    WellSpan Health (Waynesboro, PA)
    …Required **Work Experience:** + 2 years Recent acute care experience. Required + Utilization management , care management , or clinical nursing specialty. ... of the department **General Summary** Performs a variety of duties and applies utilization and care management techniques to determine the most efficient use… more
    WellSpan Health (12/04/25)
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  • Home Health Professional Staff Nurse

    UPMC (Coudersport, PA)
    …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... UPMC Home Health is hiring a Registered Nurse...patients' needs. *RN will coordinate case management activities across a multi-disciplinary health care team to… more
    UPMC (12/09/25)
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  • Home Health Admissions Nurse

    UPMC (Seven Fields, PA)
    …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... Home Health is Hiring a Full-Time Admissions Registered Nurse (RN) in the McKnight, Allison Park, Etna, Glenshaw...patients' needs. + RN will coordinate case management activities across a multi-disciplinary health care team to… more
    UPMC (12/06/25)
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  • Registered Nurse Home Health

    UPMC (Altoona, PA)
    …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... GROWING OUR UPMC HOME HEALTH TEAM FOR RN OPENINGS IN ALTOONA...CAMBRIA, SOMERSET, HUNTINGDON, MIFFLIN, AND CENTRE. Are you a nurse looking for a rewarding career where you can… more
    UPMC (12/09/25)
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  • Home Health Professional Staff Nurse

    UPMC (Pittsburgh, PA)
    …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... **UPMC Home Health is hiring a Registered Nurse...patients' needs. + RN will coordinate case management activities across a multi-disciplinary health care team to… more
    UPMC (12/08/25)
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  • Home Health Registered Nurse Tioga…

    UPMC (Wellsboro, PA)
    …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... UPMC Home Health is Hiring a Registered Nurse...patients' needs. + RN will coordinate case management activities across a multi-disciplinary health care team to… more
    UPMC (12/08/25)
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  • Home Health Nurse Bethel Park…

    UPMC (Seven Fields, PA)
    …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... UPMC Home Health is hiring a casual RN supporting...Upper St. Claire, and surrounding areas. Are you a nurse looking for a rewarding career where you can… more
    UPMC (12/08/25)
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  • Registered Nurse - Home Health 7-7…

    WellSpan Health (Gettysburg, PA)
    …plan of care, the patient's diagnosis, corporate policy and procedures and the Nurse Practice Act. Carries primary care management functions for assigned ... Eligible **General Summary** Provides professional nursing services to individuals in the home through a process of nursing assessment, planning, care and evaluation… more
    WellSpan Health (10/03/25)
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  • Licensed Practical Nurse - Home

    WellSpan Health (Lebanon, PA)
    …**General Summary** Provides comprehensive family-oriented nursing services to individuals in the home setting by use of the nursing process in accordance with ... the established plan of care, corporate policy and procedures, and the Nurse Practice Act. **Duties and Responsibilities** **Essential Functions:** + Participates in… more
    WellSpan Health (10/14/25)
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  • Professional Staff Nurse - Home

    UPMC (Seven Fields, PA)
    …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... UPMC Home Health is hiring a full-time RN for Butler...ladder for nursing that starts with a Professional Staff Nurse and leads to Expert Nurse and beyond.… more
    UPMC (12/09/25)
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  • Registered Nurse - Case Manager - PRN

    WellSpan Health (Lebanon, PA)
    …**Duties and Responsibilities** + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for continued ... quality and cost of care efforts. + Liaisons between utilization management team, third party payers, and...develops a discharge plan, and coordinates discharge needs (DME, Home Health, IV antibiotics, etc.) in collaboration with patients,… more
    WellSpan Health (11/15/25)
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  • Registered Nurse Supervisor (2nd Shift)…

    Commonwealth of Pennsylvania (PA)
    Registered Nurse Supervisor (2nd Shift) - South Mountain Restoration Center Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5141567) Apply  ... Registered Nurse Supervisor (2nd Shift) - South Mountain Restoration Center...Forest, South Mountain Restoration Center is a skilled nursing home facility that provides long-term care and is operated… more
    Commonwealth of Pennsylvania (12/04/25)
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  • Inpatient Social Worker (MSW) or Registered…

    St. Luke's University Health Network (Stroudsburg, PA)
    …, including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director. . Facilitates communication among all ... regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the complex discharge… more
    St. Luke's University Health Network (11/03/25)
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