• Utilization Management Nurse

    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 (09/12/25)
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  • Utilization Management Nurse

    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 (11/08/25)
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  • Utilization Management Nurse

    Humana (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse within the Clinical Access Grievance Team utilizes ... care management and utilization management skills...are available as needed. The Clinical Access Grievance Team Nurse uses clinical knowledge, communication skills, and independent critical… more
    Humana (11/08/25)
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  • Utilization Management Nurse

    Humana (Harrisburg, PA)
    …Work hours will be an 8.5-hour shift between 7:00am - 5:00pm CST. The Utilization Management Nurse 2 uses knowledge, communication, and independent critical ... Qualifications** + Associate's Degree or higher + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary...a team **Preferred Qualifications** + BSN + Knowledge of Utilization Management + Previous Medicare and Medicaid… more
    Humana (11/12/25)
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  • Utilization Management Appeals…

    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 (11/12/25)
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  • SNF Utilization Management RN…

    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 (09/12/25)
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  • UM Coordinator - Utilization

    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
    Penn State Health (11/11/25)
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  • Clinical UM Nurse

    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
    CenterWell (11/12/25)
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  • Utilization Management Clinical…

    CVS Health (Harrisburg, PA)
    …experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult… more
    CVS Health (11/06/25)
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  • Disease Management Nurse - Remote

    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
    Sharecare (10/22/25)
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  • Nurse

    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
    Veterans Affairs, Veterans Health Administration (11/04/25)
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  • Nurse (Assistant Nurse Manager)

    Veterans Affairs, Veterans Health Administration (Lebanon, PA)
    Summary The Revenue Utilization Review (RUR) Assistant Nurse Manager (ANM) is accountable to the CPAC Director and RUR Nurse Manager, manages RUR Nurses and ... of the United States. The position is a Registered Nurse (RN) who assists to control costs for a...as a competent consultant in clinical practice and revenue utilization review. *Systematically evaluating current practice, and formulating outcomes… more
    Veterans Affairs, Veterans Health Administration (11/04/25)
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  • Licensed Practical Nurse - MG Pain…

    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 (10/22/25)
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  • Registered Nurse - Patient Aligned Care…

    Veterans Affairs, Veterans Health Administration (Perry Point, MD)
    …promotion, health education and coaching on wellness, disease prevention, and chronic care management . The nurse will assist in directing the provision of ... Summary The Patient Aligned Care Team (PACT) Outpatient Staff Registered Nurse (RN) is responsible for providing competent primary care to patients and oversight of… more
    Veterans Affairs, Veterans Health Administration (11/04/25)
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  • Assistant Nurse Manager, 4 Lime Total Ortho…

    Penn Medicine (Lancaster, PA)
    …Friday workweek. **Summary:** + Position Summary: + Under the direction of the Nurse Manager, the Assistant Nurse Manager assesses, plans, implements and ... to the primary duties listed above: + In collaboration with the Nurse Manager, counsels employees and takes appropriate disciplinary action for infractions of… more
    Penn Medicine (11/06/25)
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  • Registered Nurse - Recruiter

    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 (11/12/25)
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  • Registered Nurse - Wound Care

    Veterans Affairs, Veterans Health Administration (Lebanon, PA)
    …promotion, health education and coaching on wellness, disease prevention, and chronic care management . The nurse will assist in directing the provision of ... Surgery Specialty Clinics. Responsibilities The Specialty Care Outpatient Staff Registered Nurse (RN) in Wound Care is responsible for providing competent,… more
    Veterans Affairs, Veterans Health Administration (11/12/25)
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  • Case Manager, Registered Nurse - Fully…

    CVS Health (Harrisburg, PA)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse more
    CVS Health (11/07/25)
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  • Registered Nurse (RN), 4 Lime Total Ortho…

    Penn Medicine (Lancaster, PA)
    …as defined by the American Nurses Association standards of nursing practice. The Clinical Nurse 1 New to Practice/Apprentice is a newly licensed new to practice RN ... safe practice within the organizational professional practice model. The Clinical Nurse 1 New to Practice/Apprentice seeks guidance to integrate concepts, knowledge,… more
    Penn Medicine (11/06/25)
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  • Registered Nurse (RN), Crisis Walk…

    Penn Medicine (Lancaster, PA)
    …as defined by the American Nurses Association standards of nursing practice. The Clinical Nurse 2 Colleague is an RN that practices as a full partner on the ... demonstrates safe practice within the organizational professional practice model. The Clinical Nurse 2 Colleague possesses the knowledge, skills and the attitude to… more
    Penn Medicine (11/06/25)
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