- Possession of a current license to practice as a Registered Nurse issued by the Pennsylvania State Board of Nursing; or Possession of a non-renewable temporary practice permit issued by the Pennsylvania State Board of Nursing.
- Resources possessing non-renewable temporary practice permits must obtain licensure as a Registered Nurse within the one-year period as defined by the Pennsylvania State Board of Nursing.
- Proficient writing and basic Computer Skills to include, but not limited to, Microsoft Office Products
- 3 years of professional experience with medical assistance (MA), health care services, or human services
- Minimum of 3 years of recent (within the last five years) professional experience in one or more of the following areas as related to the position need: long term care, acute care setting, behavioral health setting, drug and alcohol setting, managed care, quality management/utilization review or other related clinical experience; or
- An equivalent combination of experience and training in the field of medical assistance (MA), health care services, human services, long term care, utilization review, or knowledge of home care
- Knowledge of and familiarity with the following would be beneficial: Inter- Qual criteria, ICD-9 CM, and current procedure terminology, ability to use professional judgment in identifying aberrant patterns and determining the appropriate action to be taken following the documentation review.
- This is work in the review and evaluation of the medical necessity, appropriateness, quality, quantity, adequacy, and compensability of medical care and services rendered by service providers under the Medical Assistance Program.
- A resource is responsible for the review and evaluation of medical information and examination of medical records and other documentation to assure that eligible medical assistance recipients receive appropriate and quality medical care that the Medical Assistance Program is properly billed, and that provider and/or recipient fraud and abuse of the Medical Assistance Program is detected and corrected.
- Work involves the analysis and evaluation of documentation submitted by Medical Assistance Program service providers and generated through PROMISe' in order to make professional medical judgments regarding the appropriateness of the care and services provided to eligible recipients under the Medical Assistance Program.
- Reviews may be conducted in central office with the Medical Assistance Program service provider furnishing the necessary medical records, on site at the facility, or information may be provided over the telephone for any service that may require prior authorization or post certification.
- Work may include serving as a team leader on reviews requiring more than one staff member organizing and coordinating the review process.
- Resources also provide advisory and consultative services to boards and staff designed to improve the services or administrative procedures in support of medical assistance patients.
- Work may also involve the resource representing the Department in an official capacity during an appeal process.
- Judgment and discretion are required in conferring with advisory boards, facility officials, providers, and staff.
-
Registered Nurse
3 weeks ago
Geisinger Home Health Camp Hill, United States Full timeWe are hiring for a Registered Nurse. · At Geisinger Home Health, a part of the LHC Group, we embrace a culture of caring, belonging, and trust and enjoy the meaningful connections that come from it: for the whole patient, their families, each other, and the communities we serve— ...
-
Registered Nurse
2 days ago
Medical Solutions Harrisburg, United States Travel$ $ wk (includes wage of ~$15.75-$18.07/hr and per diems if eligible) · click for benefits and other job details · ~$567-$650.45 weekly taxable income · ~$ in non-taxable per diem (amount subject to eligibility & seasonal/annual adjustment) · Gather 'round, aspiring travel clinic ...
-
registered nurse
3 days ago
Grane Home Health & Hospice Harrisburg, United States Full timeOur Company: · Grane Home Health & Hospice · Overview: · Are you a Registered Nurse looking for a new opportunity? Grane Hospice is seeking a passionate, dedicated Hospice On Call RN to join our team in Harrisburg, PA Along with enjoying the benefits of flexibility and autonomy, ...
-
Registered Nurse
4 days ago
CareerStaff Unlimited Harrisburg, United StatesRegistered Nurse - RN - LTAC · CareerStaff Unlimited - Harrisburg, PA · Job Attributes · Qualifications · Years of Experience Not Stated · Certifications RN · Job Features · Shifts Variable · Shift Length 12 · Registered Nurse - RN - LTAC · Invest in your future by discovering a ...
-
Registered Nurse
3 days ago
CareerStaff Unlimited West End, United States contractRegistered Nurse - RN - LTAC · CareerStaff Unlimited - Harrisburg, PA · Job Attributes · Qualifications · Years of Experience Not Stated · Certifications RN · Job Features · Shifts Variable · Shift Length · Registered Nurse - RN - LTAC · Invest in your future by discovering a fa ...
-
Registered Nurse
3 weeks ago
FRESENIUS MEDICAL CENTER Harrisburg, United StatesPURPOSE AND SCOPE: · The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, ...
-
Registered Nurse
3 days ago
CareerStaff Unlimited West End, United States contractRegistered Nurse - RN - LTAC · CareerStaff Unlimited - Harrisburg, PA · Job Attributes · Qualifications · Years of Experience Not Stated · Certifications RN · Job Features · Shifts Variable · Shift Length 12 · Registered Nurse - RN - LTAC · Invest in your future by discovering a ...
-
Registered Nurse
4 days ago
Bluebird Staffing Harrisburg, United StatesJob Description · Facility: Critical Illness and Rehab · Position: Registered Nurse, Clinic · Location: Harrisburg, PA · Shift Details: Night · Hours per Week: 36 · Shift Hours: - · Duration: weeks · On Call: No · Benefits · Bluebird Features and Benefits : · Competitive c ...
-
Registered Nurse
2 days ago
Medical Solutions Harrisburg, United States Travel$ $ wk (includes wage of ~$15.75-$18.07/hr and per diems if eligible) · click for benefits and other job details · ~$567-$650.45 weekly taxable income · ~$ in non-taxable per diem (amount subject to eligibility & seasonal/annual adjustment) · Gather 'round, aspiring travel clinic ...
-
Registered Nurse
1 day ago
Medical Solutions Harrisburg, United States$ $ wk (includes wage of ~$16.50-$17.91/hr and per diems if eligible) · click for benefits and other job details · ~$594-$644.79 weekly taxable income · ~$ in non-taxable per diem (amount subject to eligibility & seasonal/annual adjustment) · Gather 'round, aspiring travel clinic ...
-
Registered Nurse
3 days ago
CareerStaff Unlimited West End, United States contractRegistered Nurse - RN - LTAC · CareerStaff Unlimited - Harrisburg, PA · Job Attributes · Qualifications · Years of Experience One-Plus Years · Certifications RN · Job Features · Shifts Variable · Shift Length · Registered Nurse - RN - LTAC · Invest in your future by discovering ...
-
Registered Nurse
1 day ago
Medical Solutions Harrisburg, United States$ $ wk (includes wage of ~$15.75-$18.07/hr and per diems if eligible) · click for benefits and other job details · ~$567-$650.45 weekly taxable income · ~$ in non-taxable per diem (amount subject to eligibility & seasonal/annual adjustment) · This Med Surg (Medical Surgical) in R ...
-
Registered Nurse
2 weeks ago
Helen M. Simpson Rehabilitation Hospital Harrisburg, United States Part time-12 Hour Shift NightsOverview · Helen M Simpson Rehabilitation Hospital · *A joint venture with Select Medical & UPMC Pinnacle* · Hummelstown, PA · Registered Nurse (RN) - Part Time Nights · 7a-7:30p, 2 days per week · $6,000 sign on bonus · Pay: Up to $49.17 per hour · based on years of exper ...
-
Registered Nurse
1 week ago
Oak Hill Village Harrisburg, United States*$5,000 SIGN ON BONUS* · Looking for day shift and night shift · Oak Hill Village is now under new management and hiring full-time and part-time RNs who are committed to providing the best life and care for our residents. If you are looking forward to becoming a part of a dynami ...
-
Registered Nurse
7 hours ago
Penn State Health Enola, PA, United StatesPenn State Health - Hampden Medical Center · Location: US:PA:Enola · Work Type: Part Time · FTE: 0.60 · Shift: Night · Hours: 12 hours/Nights · Recruiter Contact: Kathryn Rush at · SUMMARY OF POSITION: · The RN inpatient Nurse assesses patient health problems and needs, develop ...
-
Registered Nurse
2 days ago
Medical Solutions Mechanicsburg, United States Travel$1591-$ wk (includes wage of ~$15.75-$16.77/hr and per diems if eligible) · click for benefits and other job details · ~$567-$603.84 weekly taxable income · ~$1024 in non-taxable per diem (amount subject to eligibility & seasonal/annual adjustment) · Where will care take you? How ...
-
Registered Nurse
1 week ago
Avera McKennan Hospital Careers Harrisburg, United States Permanent, Full timeJoin the RN Nursing team at Avera · Magnet Recognized: Avera McKennan Hospital & University Health Center has received consecutive ANCC Magnet re-designations for meeting rigorous standards for nursing excellence and job satisfaction. · Culture: Be part of a multidisciplinary te ...
-
Registered Nurse
2 weeks ago
LHC Group Camp Hill, United States Full timeWe are hiring for a Registered Nurse . · At Geisinger Home Health, a part of the LHC Group, we embrace a culture of caring, belonging, and trust and enjoy the meaningful connections that come from it: for the whole patient, their families, each other, and the communities we serv ...
-
Registered Nurse
3 weeks ago
Amedisys Harrisburg, PA, United StatesOverview · $ 25,000 sign-on bonus · Full-time days · Are you a highly skilled and compassionate registered nurse (RN) looking for a rewarding career in homecare? If so, we invite you to join our team at Amedisys, one of the largest and most trusted home health and hospice compani ...
-
Registered Nurse
2 days ago
Medical Solutions Mechanicsburg, United States Travel$ $ wk (includes wage of ~$15.75-$17.87/hr and per diems if eligible) · click for benefits and other job details · ~$567-$643.33 weekly taxable income · ~$ in non-taxable per diem (amount subject to eligibility & seasonal/annual adjustment) · Are you ready to choose your next adv ...
Registered Nurse - Harrisburg, United States - Trident Development Corporation
2 weeks ago
Description
Job Description
Job DescriptionMinimum Qualifications
Role Description