- R1 RCM (Pittsburgh, PA)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our ... have experience in a clinical inpatient environment and hospital-based utilization or case management experience. Proficiency in...position. **Here's what you will experience working as a Utilization Review Nurse :** + Perform… more
- CVS Health (Harrisburg, PA)
- …live in any state. There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant...Word, Excel, Outlook) Preferred Qualifications: - 1+ years' experience Utilization Review experience - 1+ years' experience… more
- Insight Global (Philadelphia, PA)
- …A Healthcare Insurance company local to Philadelphia PA is looking to hire a Utilization Management Nurse (RN) to their delegation oversight & assessment ... license 2+ years of experience working in Utilization Review or Utilization Management with commercial payers or medicare/medicaid Experience/knowledge… more
- Geisinger (Danville, PA)
- …re-admissions. + Assesses and recommends policies as they relate to readmissions and utilization review activities. + Reviews inpatient level of care and ... Medical Management and Senior Medical Director. + Provides initial review of written provider appeal process; reviews additional information provided, has… more
- Lincoln Financial Group (Harrisburg, PA)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... 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
- Humana (Harrisburg, PA)
- … management personnel and oversee all utilization management functions, including inpatient admissions, concurrent review , prior authorization, and ... put health first** Humana Healthy Horizons in Virginia is seeking a Manager, Utilization Management (Behavioral Health) who will utilize their clinical skills to… more
- UPMC (Pittsburgh, PA)
- …+ One (1) year of health insurance experience, and experience in clinical, utilization management , home care, discharge planning, and/or case management ... clinical and social history, current medications, geriatric syndromes, healthcare resource utilization , case management interventions. Updates the plan of care… more
- Commonwealth of Pennsylvania (PA)
- Registered Nurse Supervisor Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4508736) Apply Registered Nurse Supervisor Salary $92,281.00 - ... THE POSITION Are you a compassionate and motivated Registered Nurse who wants to lead others and be an...care. Critical components of this position include the continual review of nursing services, serving as a patient advocate,… more
- Health Advocates Network (Harrisburg, PA)
- …setting, behavioral health setting, drug and alcohol setting, managed care, quality management / utilization review or other related clinical experience; or ... R&E Nurse - Med Care Services- Advanced **Pay Rate** :...(MA), health care services, human services, long term care, utilization review , or knowledge of home care… more
- Guthrie (Sayre, PA)
- Position Summary: Facilitate efficient, effective pain prevention and management practices for inpatients under the direction and supervision of the Pain Service; ... develop pain prevention and management plans for patients though collaborating with the patients,...non‐pharmaceutical best practices. Education, License & Cert: * Registered Nurse in the State of Practice. Start of BSN… more
- Health Advocates Network (Frackville, PA)
- …shift. Charge nurses make assessments and decisions in regard to staff utilization and supplies and equipment needs. Charge nurse supervises paraprofessional ... of professional nursing practices. Work is reviewed and evaluated by a Registered Nurse Supervisor, physician or dentist through observation, review of reports… more
- Lancaster General Health (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
- Lancaster General Health (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
- Lancaster General Health (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
- Lancaster General Health (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
- Lancaster General Health (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
- WellSpan Health (Mount Gretna, PA)
- …of alternative treatment settings to provide appropriate care. + Coordinate with Case Management as indicated. + Participates in the review of policy and ... Care Nurse Coordinator RN - Child Adolescent Inpatient -...assigned patients using Motivational Interviewing strategies in the active management of their health by encouraging participation in their… more
- Carbon Lehigh Intermediate Unit 21 (Schnecksville, PA)
- Contracted Classroom Nurse JobID: 691 + Position Type: CONTRACTED SERVICES/ Contracted Classroom Nurse + Date Posted: 9/15/2023 + Location: Schnecksville, PA ... and Services under the clinical guidance from the Certified School Nurse . Qualifications: Education/Experience: + Bachelor's Degree in nursing (BSN). + Valid… more
- Lancaster General Health (Lancaster, PA)
- …and that established outcomes are achieved through availability and appropriated utilization of human, material and financial resources. + Educates patients about ... improvement activities with an emphasis on increasing continuity in the nurse to patient relationship, minimizing rework and redundancies; constantly seeks ways… 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