- CVS Health (Harrisburg, PA)
- …can live in any state. There is no travel expected with this position. As a Utilization Management Nurse Consultant , you will utilize clinical skills to ... to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee… 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 possess 1+ years of clinical experience… 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
- Lincoln Financial Group (Harrisburg, PA)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization....will provide coaching and guidance to claims regarding medical management **What you'll be doing** * Evaluate medical information… more
- Highmark Health (Camp Hill, PA)
- …+ Performs as the clinical subject matter expert for clinical, quality, care, utilization , high cost claim and population health management as the part ... stay current on health, wellness, productivity, risk and care management trends in the market place in order to...or CERTIFICATIONS** **Required** (any of the following) + Registered Nurse (RN) + Physician Assistant License - PA +… more
- Penn Medicine (Philadelphia, PA)
- …a redesigned front end to expedite patient flow. **Summary:** + The Clinical Nurse Educator (CNE) practices within the UPHS professional practice model and exhibits ... that includes the traditional components of patient care, consultation, research utilization and education with the aims of upholding practice standards,… more
- Geisinger (Wilkes-Barre, PA)
- …including practice analysis, inpatient hospital and extended care facility utilization reviews, medical audits, ambulatory care reviews, claims reviews, and ... specifically those related to customer service, patient satisfaction and clinical risk management . Job Duties + Collects and analyzes patient complaint and grievance… more
- Highmark Health (Pittsburgh, PA)
- …Oversees and ensures that standards of care are maintained relative to quality management , utilization review, and discharge planning. + Accountable to ensure ... an environment of transparency with the use of visual management boards on nursing units. + Promotes staff participation...Governance model in all departments. + Serves as a consultant for nurse managers and medical staff… more