- 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...action. Humana is seeking a Part C Grievance & Appeals (G&A) Nurse who will assist in… more
- Sharecare (Harrisburg, PA)
- …open enrollment / new hire plan selection, claims issues, ID card issues, grievances/ appeals , utilization management (UM) status, including but not limited ... 3rd parties for: + Claims adjustments + Grievances and appeals submissions + Utilization management ...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more