Utilization Management Nurse Jobs in Pennsylvania
Utilization Management Nurse jobs in Pennsylvania are consistently in demand, concentrated in health insurance, managed care, and large integrated health systems serving one of the country's most densely populated states, with openings at every level from staff reviewer through senior clinical coordinator. The most active hiring metros are Philadelphia, Pittsburgh, and Harrisburg, where employers such as Independence Blue Cross, UPMC, and Highmark Health maintain large utilization management teams. Case management review, prior authorization, and discharge planning are the specialties drawing the most consistent interest from Pennsylvania employers. Find a role that fits below and apply directly.
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Invest in Your Future and Theirs: Full-time Milton S. Hershey Medical Center employees receive a 75% Penn State tuition discount for themselves and eligible dependents through the Grant-in-Aid program.
Penn State Health - Hershey Medical Center
Location: US:PA: Hershey
Work Type: Part Time
FTE: 0.50
Shift: Day
Hours: 7:00a - 11:00p
Recruiter Contact: Denisse M. Rosado at drosado1@pennstatehealth.psu.edu
SUMMARY OF POSITION:
Responsible for providing support to the Utilization Management team including assistance with post payment denials and pre-payment authorizations.
MINIMUM QUALIFICATION(S):
- High School Diploma or equivalent required.
- One (1) year registration/billing experience required.
WHY PENN STATE HEALTH?
Penn State Health offers exceptional opportunities to learn and grow, exposure to a wide patient population, and the ability to provide individualized, innovative, and specialized care to patients in the community.
Penn State Health offers an exceptional benefits package including medical, dental and vision with no waiting period as well as a Total Rewards Program that highlights a few of the many additional offerings below:
- Be Well with Employee Wellness Programs, and Fitness Discounts (University Fitness Center, Peloton).
- Be Balanced with Generous Paid Time Off, Personal Time, and Paid Parental Leave.
- Be Secured with Retirement, Extended Illness Bank, Life Insurance, and Identity Theft Protection.
- Be Rewarded with Competitive Pay, Tuition Reimbursement, and PAWS UP employee recognition program.
- Be Supported by the HR Solution Center, Learning and Organizational Development and Virtual Benefits Orientation, Employee Exclusive Concierge Service for scheduling.
WHY PENN STATE HEALTH MILTON HERSHEY MEDICAL CENTER?
Penn State Hershey Medical Center is Central Pennsylvania’s only Academic Medical Center, Level 1 Regional Adult and Pediatric Trauma Center, and Tertiary Care Provider. As a four-time Magnet-designated hospital, Hershey Medical Center values the hard work and dedication that our employees exhibit every day. Through our core values of Respect, Integrity, Teamwork, and Excellence, our employees are a team committed to compassionate care for our diverse patient population, our community and each other. As a valued team member, we promote continued professional development, specialty certification, continuing education, and career growth.
YOU TAKE CARE OF THEM. WE’LL TAKE CARE OF YOU. State-of-the-art equipment, endless learning, and a culture of excellence – that’s Penn State Health. But what makes our healthcare award-winning? That’s all you.
This job posting is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. Eligibility for shift differential pay based on the terms outlined in company policy or union contract. All individuals (including current employees) selected for a position will undergo a background check appropriate for the position's responsibilities.
Penn State Health is an Equal Opportunity Employer and does not discriminate on the basis of any protected class including disability or veteran status. Penn State Health’s policies and objectives are in direct compliance with all federal and state constitutional provisions, laws, regulations, guidelines, and executive orders that prohibit or outlaw discrimination.
Union: Non Bargained
Invest in Your Future and Theirs: Full-time Milton S. Hershey Medical Center employees receive a 75% Penn State tuition discount for themselves and eligible dependents through the Grant-in-Aid program.
Penn State Health - Hershey Medical Center
Location: US:PA: Hershey
Work Type: Part Time
FTE: 0.50
Shift: Day
Hours: 7:00a - 11:00p
Recruiter Contact: Denisse M. Rosado at drosado1@pennstatehealth.psu.edu
SUMMARY OF POSITION:
Responsible for providing support to the Utilization Management team including assistance with post payment denials and pre-payment authorizations.
MINIMUM QUALIFICATION(S):
- High School Diploma or equivalent required.
- One (1) year registration/billing experience required.
WHY PENN STATE HEALTH?
Penn State Health offers exceptional opportunities to learn and grow, exposure to a wide patient population, and the ability to provide individualized, innovative, and specialized care to patients in the community.
Penn State Health offers an exceptional benefits package including medical, dental and vision with no waiting period as well as a Total Rewards Program that highlights a few of the many additional offerings below:
- Be Well with Employee Wellness Programs, and Fitness Discounts (University Fitness Center, Peloton).
- Be Balanced with Generous Paid Time Off, Personal Time, and Paid Parental Leave.
- Be Secured with Retirement, Extended Illness Bank, Life Insurance, and Identity Theft Protection.
- Be Rewarded with Competitive Pay, Tuition Reimbursement, and PAWS UP employee recognition program.
- Be Supported by the HR Solution Center, Learning and Organizational Development and Virtual Benefits Orientation, Employee Exclusive Concierge Service for scheduling.
WHY PENN STATE HEALTH MILTON HERSHEY MEDICAL CENTER?
Penn State Hershey Medical Center is Central Pennsylvania’s only Academic Medical Center, Level 1 Regional Adult and Pediatric Trauma Center, and Tertiary Care Provider. As a four-time Magnet-designated hospital, Hershey Medical Center values the hard work and dedication that our employees exhibit every day. Through our core values of Respect, Integrity, Teamwork, and Excellence, our employees are a team committed to compassionate care for our diverse patient population, our community and each other. As a valued team member, we promote continued professional development, specialty certification, continuing education, and career growth.
YOU TAKE CARE OF THEM. WE’LL TAKE CARE OF YOU. State-of-the-art equipment, endless learning, and a culture of excellence – that’s Penn State Health. But what makes our healthcare award-winning? That’s all you.
This job posting is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. Eligibility for shift differential pay based on the terms outlined in company policy or union contract. All individuals (including current employees) selected for a position will undergo a background check appropriate for the position's responsibilities.
Penn State Health is an Equal Opportunity Employer and does not discriminate on the basis of any protected class including disability or veteran status. Penn State Health’s policies and objectives are in direct compliance with all federal and state constitutional provisions, laws, regulations, guidelines, and executive orders that prohibit or outlaw discrimination.
Union: Non Bargained
See All 8 Utilization Management Nurse Jobs in Pennsylvania
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Find JobsUtilization Management Nurse Jobs by City in Pennsylvania
Where Pennsylvania roles are concentrated, by current openings.
Utilization Management Nurse Job Market in Pennsylvania
A snapshot from current Pennsylvania openings, updated as new roles post.
Who's Hiring
Top Industries Hiring
- Technology & Software
What Pennsylvania Employers Look For
The qualifications that appear most often in utilization management nurse jobs across Pennsylvania.
- Active registered nurse license issued or recognized by the Pennsylvania State Board of Nursing
- Associate or bachelor's degree in nursing from an accredited program required
- Minimum two to three years of clinical nursing experience in an acute care or managed care setting
- Working knowledge of InterQual or Milliman criteria for clinical review and authorization decisions
- Certified Case Manager or Accredited Case Manager certification preferred by most Pennsylvania employers
- Proficiency with electronic health records and utilization management platforms such as Utilization Review Accreditation Commission standards
Utilization Management Nurse Jobs in Pennsylvania: Frequently Asked Questions
How do you become a utilization management nurse in Pennsylvania?
You must first hold an active registered nurse license issued by the Pennsylvania State Board of Nursing, which requires passing the NCLEX-RN exam after completing an accredited associate or bachelor's degree nursing program. From there, most Pennsylvania employers expect at least a few years of clinical experience before moving into utilization management. Pursuing a Certified Case Manager credential strengthens your candidacy and is increasingly expected by larger health systems and insurers in the state.
Which companies hire utilization management nurses in Pennsylvania?
Employers hiring utilization management nurses in Pennsylvania right now include Highmark Health, Optum, and IntePros, based on current listings on Migrate Mate as of October 2026. Pennsylvania's dense concentration of integrated health systems and regional insurers means utilization management roles appear across both payer and provider sides of the market.
Which Pennsylvania cities have the most utilization management nurse jobs?
Pennsylvania, Darby, and Hershey lead Pennsylvania for utilization management nurse openings. Philadelphia anchors the southeast with the headquarters of major insurers like Independence Blue Cross alongside Jefferson Health and Penn Medicine, while Pittsburgh's concentration around UPMC and Highmark Health drives strong demand there, and Harrisburg draws openings tied to state government health programs and regional managed care organizations.
Are there remote utilization management nurse jobs in Pennsylvania?
Yes, and more than most nursing roles. Because utilization management work centers on chart review, prior authorization, and care coordination rather than hands-on patient care, it translates well to remote settings. About 60% of utilization management nurse openings tied to Pennsylvania are remote or hybrid as of October 2026, reflecting the desk-based nature of the work. Prior authorization review and telephonic case management are the functions most commonly offered as fully remote positions.
How can I get hired as a utilization management nurse in Pennsylvania with little or no experience?
The most realistic entry path is lateral movement from a clinical case manager, discharge planner, or care coordinator role within a Pennsylvania hospital system such as UPMC, Jefferson Health, or Penn Medicine, where internal transfers into utilization management are common. Completing a Certified Case Manager credential while still in a bedside or care coordination role signals readiness to hiring managers. Some regional insurers in Pennsylvania also post junior utilization review positions that accept candidates with strong acute care backgrounds and train on-the-job for criteria application.
Where can I find and apply to utilization management nurse jobs in Pennsylvania?
You can find and apply to utilization management nurse jobs in Pennsylvania on Migrate Mate, which lists current Pennsylvania openings from health systems, insurers, and managed care organizations across the state. Find roles that fit your experience and specialty focus, then apply directly to the employer.
See All 8 Utilization Management Nurse Jobs in Pennsylvania
Find roles in Pennsylvania that match your experience and apply in just a few clicks.
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