- CVS Health (Harrisburg, PA)
- …And we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- Humana (Harrisburg, PA)
- …help us put health first** Full-Time, Remote Telephonic opportunity 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
- Cognizant (Harrisburg, PA)
- …. Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan ... 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 … more
- Humana (Harrisburg, PA)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
- CVS Health (Harrisburg, PA)
- … (UM) Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all ... and state regulated turn-around times. This includes reviewing written clinical records. **Key Responsibilities of the UM Nurse...practice experience as an RN required. + 2+ Years Utilization Management experience. + Must be willing… more
- CVS Health (Harrisburg, PA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Harrisburg, PA)
- … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
- WellSpan Health (York, PA)
- …a culture of quality, safety and efficient care. Assists the Director of Clinical Operations in management of staff to deliver high quality, patient-centered ... leadership and Medical Group practice experience. Required + Lean Daily Management experience. Preferred **Licenses:** + Licensed Registered Nurse Upon… more
- Evolent (Harrisburg, PA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. Acts as a member advocate by… more
- Sharecare (Harrisburg, PA)
- …helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… 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 ... + 1 year Clinical nursing experience. Required **Licenses:** + Licensed Practical Nurse Upon Hire Required or + Licensed Practical Nurse Multi State License… more
- 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 ... demonstrates basic safe practice within the organizational professional practice model. The Clinical Nurse 1 New to Practice/Apprentice seeks guidance to… more
- Penn Medicine (Lancaster, PA)
- …and accountability as defined by the American Nurses Association standards of nursing practice. The Clinical Nurse 2 Colleague is an RN that practices as a full ... consistently demonstrates safe practice within the organizational professional practice model. The Clinical Nurse 2 Colleague possesses the knowledge, skills and… more
- Penn Medicine (Lancaster, PA)
- …and accountability as defined by the American Nurses Association standards of nursing practice. The Clinical Nurse 2 Colleague is an RN that practices as a full ... consistently demonstrates safe practice within the organizational professional practice model. The Clinical Nurse 2 Colleague possesses the knowledge, skills and… more
- Penn Medicine (Lancaster, PA)
- …Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn ... + Position Summary: + Under the direction of the Nurse Manager, the Assistant Nurse Manager assesses,...and ensures continuity of care based on knowledge of clinical nursing needs of patients. + Collects objective data… more
- CVS Health (Harrisburg, PA)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... self-insured clients. + Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures… more
- UPMC (Harrisburg, PA)
- …the nursing process. In collaboration with the health care team, the Programmatic Nurse Specialist applies expert clinical knowledge and skills to achieve ... and rewarding areas of pediatric medicine. Purpose: The Programmatic Nurse Specialist, a professional registered nurse , has... experience + Minimum of 2 years of relevant clinical specialty experience + Leadership and project management… more
- WellSpan Health (Gettysburg, PA)
- …plan of care, the patient's diagnosis, corporate policy and procedures and the Nurse Practice Act. Carries primary care management functions for assigned ... existing staff as requested. + Participates in the student nurse program, as delegated. + Variation of duties may...of perceived problem areas related to patient care, corporate management , or community relations. + Keeps clinical … 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 ... + 1 year Clinical nursing experience. Required **Licenses:** + Licensed Practical Nurse Upon Hire Required or + Licensed Practical Nurse Multi State License… more
- WellSpan Health (Hanover, PA)
- …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... + 1 year Clinical nursing experience. Required **Licenses:** + Licensed Practical Nurse Upon Hire Required or + Licensed Practical Nurse Multi State License… more