- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Harrisburg, PA)
- …and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** 3+ years of ... it all with heart, each and every day. _Utilization Management is a 24/7 operation and work schedule may...positions hours will be M-F with Weekend/Holiday Rotation._ **UM Nurse Consultant** Fully Remote- WFH **Position Summary** UM … more
- CVS Health (Harrisburg, PA)
- …And we do it all with heart, each and every day. **Position Summary** ** Utilization Management is a 24/7 operation and work schedules will include weekends, ... Qualifications** **- 2+ years of experience as a Registered Nurse in adult acute care/critical care setting** **- Must...and unrestricted RN licensure in state of residence** **- Utilization Management is a 24/7 operation and… more
- 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
- 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
- Penn State Health (Hershey, PA)
- …(MAILTO://###@pennstatehealth.psu.edu) **SUMMARY OF POSITION:** Under the direction of a Utilization Management Nurse or Specialist, the ... or outlaw discrimination._ **Union:** Non Bargained **Position** UM Coordinator - Utilization Management **Location** US:PA: Hershey | Clerical and… more
- Cognizant (Harrisburg, PA)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CenterWell (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability...volume and fast paced environment + Previous experience in utilization management + Education: BSN or bachelor's… more
- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- 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...or Clinical Nursing Specialty. Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered Nurse… more
- Sharecare (Harrisburg, PA)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- Veterans Affairs, Veterans Health Administration (Lebanon, PA)
- …clinical denials. Provides feedback as appropriate, for performance improvement, utilization management , and compliance related issues. Conducts precertification ... Summary The Revenue Utilization Review (RUR) nurse is under...Billing, Insurance Verification, Veteran Services, Compliance, Providers, Health Information Management (HIM), Utilization Management (UM),… more
- WellSpan Health (Lebanon, PA)
- …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... year Clinical nursing experience. Required **Licenses:** + Licensed Practical Nurse Upon Hire Required or + Licensed Practical ...Nurse Upon Hire Required or + Licensed Practical Nurse Multi State License Upon Hire Required or +… more
- Veterans Affairs, Veterans Health Administration (Lebanon, PA)
- …- Mental Health service line. Responsibilities The Domiciliary Mental Health (MH) Registered Nurse (RN) supports the Nurse Manager (NM) with duties and ... education, orientation, competencies and providing quality improvement and outcomes utilization consultation. The domiciliary RN provides patient-centered and recovery-oriented… more
- Veterans Affairs, Veterans Health Administration (Lebanon, PA)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... to receiving, triaging, and directing timely, coordinated care. The nurse demonstrates proficient practice and decision-making, deliberate planning, and critical… more
- Veterans Affairs, Veterans Health Administration (Lebanon, PA)
- Summary The Registered Nurse will serve as a Nurse Recruiter in Nursing Operations at Lebanon VA Medical Center. Responsibilities The Nurse Recruiter is ... needs. Works collaboratively with nursing administration and Human Resources (HR) Management Service and nursing leadership to meet resource needs. Forecasts needs… more
- Veterans Affairs, Veterans Health Administration (Lebanon, PA)
- Summary The Registered Nurse will serve as Restorative Nurse Coordinator at Lebanon VA Medical within Nursing, Geriatrics and Extended Care. Responsibilities The ... Restorative Registered Nurse (RN) Coordinator is responsible for providing competent, evidence-based care to assigned residents and oversight of licensed vocational… more
- Health Advocates Network (Selinsgrove, PA)
- …shift. Charge nurses make assessments and decisions in regard to staff utilization and supplies and equipment needs. Charge nurse supervises paraprofessional ... Registered Nurse (RN)DC- Short-Term **Pay Rate** : $63 /...care area, such as, infection control or quality assurance/improvement/risk management activities. Work assignments are received in the form… more