Full Time, Employee

Harrisburg, PA

We have an immediate for an LPN to join the SGC team. The LPN will assess the clinical needs of the members engaged in the Utilization Management Department in Medical Management.  Based on the clinical assessment, the Medical Management Nurse I is responsible for identifying members who have complex or ongoing needs and appropriately referring them to other programs or resources.

Qualifications include:

  • LPN with an active unrestricted PA License
  • Knowledge of URAC, and NCQA standards for case management organizations and CMSA Standards of Practice for Case Management, Act 68, NCQA, CMS, and ERISA
  • Five (5) years of clinical experience working in an acute care hospital or appropriate clinical setting
  • Knowledge of managed care principles and emerging health treatment modalities
  • Critical thinker

For more information regarding this opportunity, please send us your resume and we will be in touch right away.