- 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
- 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
- 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
- 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
- WellSpan Health (Gettysburg, PA)
- …Degree Required **Work Experience:** + 1 year Relevant experience. Required **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered ... the patient's diagnosis, corporate policy and procedures and the Nurse Practice Act. Carries primary care management functions for...of visits, phone calls and conferences in the patient's clinical record on a timely basis and legible manner.… 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
- 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
- Centene Corporation (Harrisburg, PA)
- …required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required or + ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
- UPMC (Carlisle, PA)
- The Senior Professional Staff Nurse II is a Registered Nurse , a member of the care delivery team, and responsible for seeking opportunities to assist in ... Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Pediatric Advanced Life Support (PALS) + Registered Nurse (RN) + Act 31 Child Abuse Reporting with renewal… more
- WellSpan Health (Gettysburg, 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
- Health Advocates Network (Harrisburg, PA)
- …hour *W2 Minimum Qualifications Possession of a current license to practice as a Registered Nurse issued by the Pennsylvania State Board of Nursing; or ... Nursing. Resources possessing non-renewable temporary practice permits must obtain licensure as a Registered Nurse within the one-year period as defined by the… more
- Lincoln Financial (Harrisburg, PA)
- …**What we're looking for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible… 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
- UPMC (Mechanicsburg, PA)
- …Social Worker (LSW) OR Other Healthcare Professional Licenses for Discharge Planning OR Registered Nurse (RN) *Current licensure either in the state where the ... The Manager oversees the day-to-day operations of the Clinical Care Coordination and Discharge Planning Department under the direction of the Director. The Manager… more
- UPMC (Harrisburg, PA)
- Registered Nurse Home Health Harrisburg Are you a nurse looking for a rewarding career where you can provide direct, one-on-one patient care? UPMC Home ... + Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Driver's License + Registered Nurse (RN) OR Temporary Practice Permit (TPP) + Act 33 +… more
- Penn State Health (Camp Hill, PA)
- …experience + Five (5) years management experience + Currently licensed to practice as a Registered Nurse by state of employment or holds a multistate RN license ... Department of Nursing. Serves as a resource to manage daily operations of clinical staffing with the expectation of long-term financial savings through enhanced … more
- Select Medical (Mechanicsburg, PA)
- …Current Licensure in a clinical discipline per state guidelines required. ( Registered Nurse or Social Work (SW) preferred) **Preferred Qualifications** + ... time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and appropriate… more