- Humana (Harrisburg, PA)
- …part of our caring community and help us put health first** The SNF Utilization Management Nurse uses clinical knowledge, communication skills, and ... receives guidance where needed. Follows established guidelines and procedures. The SNF Utilization Management Nurse uses clinical knowledge, communication… more
- CVS Health (Harrisburg, PA)
- …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST and CST zones.… more
- Humana (Harrisburg, PA)
- …a part of our caring community and help us put health first** The Utilization Management (UM) Director, Clinical Strategy and Practice for Medicaid builds ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director, Clinical Strategy and Practice for… more
- Zurich NA (Harrisburg, PA)
- …+ Experience in development and implementation of cost containment programs + Case management , utilization review, catastrophic or disability experience + 5 or ... AVP, Utilization Review & Pharmacy 123092 Zurich Insurance is...recruiting and retaining team members. + Drive the performance management process by communicating job expectations, monitoring and evaluating… 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
- Health Advocates Network (Harrisburg, PA)
- …shift. Charge nurses make assessments and decisions in regard to staff utilization and supplies and equipment needs. Charge nurse supervises paraprofessional ... Correctional Registered Nurse - Short-Term 40hrs Travel Package Weekly Gross Pay...care area, such as, infection control or quality assurance/improvement/risk management activities. Work assignments are received in the form… more
- Evolent (Harrisburg, PA)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and client policies and ... the culture. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a...and regulations. * Practices and maintains the principles of utilization management and appeals management … more
- WellSpan Health (Lebanon, PA)
- …+ Engages assigned patients using Motivational Interviewing strategies in the active management of their health by encouraging participation in their care and ... planning. Assistance, as needed, with patient understanding of medication management , outpatient follow up treatment, discharge transportation needs, and identifying… more
- CVS Health (Harrisburg, PA)
- …You can have life-changing impact on our members, who are enrolled in Care Management and present with a wide range of complex health and social challenges. With ... exciting opportunity as we grow and expand our Care Management Programs to change lives in new markets across...timelines. - Utilizes weekly and daily reporting to identify utilization for the purpose of reducing Emergency Department … more
- Sharecare (Harrisburg, PA)
- …total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also ... the participants and their Primary Care Provider according to the disease management program intervention guidelines. A Clinical Registered Nurse is supervised… more
- WellSpan Health (York, PA)
- …plan of care, the patient's diagnosis, corporate policy and procedures and the Nurse Practice Act. Carries primary care management functions for assigned ... patient and/or care givers in performing specific procedures. + Performs case management functions, when assigned as primary clinician. + Participates in patient… more
- WellSpan Health (York, PA)
- …surgery, arrhythmia monitoring and intervention, advanced cardiac life support, pacemaker/ICD management , IABP management , CRRT utilization , ventricular ... clinical standards of the hospital. Acts as a primary nurse for patients on the unit. Coordinates care planning...clinical standards of the hospital. Acts as a primary nurse for patients on the unit. Synthesizes patient data… more
- WellSpan Health (York, PA)
- … management , all components of advanced cardiac life support, pacemaker/ICD management , IABP management , CRRT utilization , and Impella. **General ... clinical standards of the hospital. Acts as a primary nurse for patients on the unit. Coordinates care planning...clinical standards of the hospital. Acts as a primary nurse for patients on the unit. Synthesizes patient data… 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
- WellSpan Health (York, 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
- WellSpan Health (York, PA)
- …hemodynamic monitoring, chest tubes, venous thrombolytics, arterial alteplase, ventilator management , arterial line, tracheostomy care (acute and chronic), CRRT ... utilization , EKOS catheter-directed, ultrasound thrombolysis, and TPE therapy. **General...clinical standards of the hospital. Acts as a primary nurse for patients on the unit. Coordinates care planning… more
- Genesis Healthcare (Camp Hill, PA)
- …to achieve patient goals and minimize rehospitalizations; 4.4. Actively participates in Utilization Management or InterdisciplinaryCare Management Meeting to ... Manager, ADON or ADON - Unit, or Director of Nursing ( Nurse Leader), the Registered Nurse (RN) delivers efficient and effective nursing care while achieving… more
- Highmark Health (Harrisburg, PA)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- Lincoln Financial (Harrisburg, PA)
- …Care, Orthopedics, Coronary Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like to ... 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 for… more
- Evolent (Harrisburg, PA)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company policies and… more