- Cognizant (Harrisburg, PA)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CVS Health (Harrisburg, PA)
- …we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** utilizes ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- 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 assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
- CVS Health (Harrisburg, PA)
- …shift times are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + Minimum ... solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team.… more
- WellSpan Health (York, PA)
- …practice experience. Required + Lean Daily Management experience. Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered ... Works with the Practice Managers and Site Directors to advance and standardize clinical operations throughout the system, within a culture of quality, safety and… more
- CVS Health (Harrisburg, PA)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- WellSpan Health (Lebanon, PA)
- …Management, Case Management, or Clinical Nursing Specialty. Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered ... Weekend rotation **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of… more
- CVS Health (Harrisburg, PA)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… 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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- WellSpan Health (York, PA)
- …(BSN) Preferred **Work Experience:** + 1 year of RN experience required **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered Nurse ... of advanced cardiac life support, pacemaker/ICD management, IABP management, CRRT utilization , and Impella. **General Summary** Provides professional nursing care at… more
- Genesis Healthcare (Camp Hill, PA)
- …RN Nursing Supervisor, Unit Manager, ADON or ADON - Unit, or Director of Nursing ( Nurse Leader), the Registered Nurse (RN) delivers efficient and effective ... nursing care while achieving positive clinical outcomes and patient/family satisfaction. He/she operates within the...within the scope of practice defined by the State Nurse Practice Act and delegates aspects of patient care… more
- Evolent (Harrisburg, PA)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are… more
- UPMC (Harrisburg, PA)
- …the most specialized and rewarding areas of pediatric medicine. Purpose: The Programmatic Nurse Specialist, a professional registered nurse , has the ... In collaboration with the health care team, the Programmatic Nurse Specialist applies expert clinical knowledge and...Cardiopulmonary Resuscitation (CPR) + Neonatal Resuscitation Program (NRP) + Registered Nurse (RN) + Act 31 Child… more
- WellSpan Health (Mount Gretna, PA)
- …2 years Nursing experience and recent behavioral health experience required **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered ... patient care and treatment progress. + Participates in daily communication with primary nurse , communicating any clinical concerns and assist in developing an… more
- WellSpan Health (Lebanon, PA)
- …or + Licensed Practical Nurse Multi State License Upon Hire Required or + Licensed Registered Nurse Upon Hire Required or + Registered Nurse Multi ... planning and implementation of patient care based upon sound nursing judgment, clinical preparation, knowledge, skills and experience. Nursing care is provided in… more
- WellSpan Health (Lebanon, PA)
- …or + Licensed Practical Nurse Multi State License Upon Hire Required or + Licensed Registered Nurse Upon Hire Required or + Registered Nurse Multi ... planning and implementation of patient care based upon sound nursing judgment, clinical preparation, knowledge, skills and experience. Nursing care is provided in… more
- 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 ... planning and implementation of patient care based upon sound nursing judgment, clinical preparation, knowledge, skills and experience. Nursing care is provided in… more
- 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 ... planning and implementation of patient care based upon sound nursing judgment, clinical preparation, knowledge, skills and experience. Nursing care is provided in… more
- Sharecare (Harrisburg, PA)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
- Highmark Health (Camp Hill, PA)
- …external client facing **LICENSES or CERTIFICATIONS** **Required** (any of the following) + Registered Nurse (RN) + Physician Assistant License - PA + Pharmacist ... + Performs as the clinical subject matter expert for clinical , quality, care, utilization , high cost claim and population health management as the part of… more