- Highmark Health (Harrisburg, PA)
- …effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate ... identification and resolution of quality issues. Monitors and analyzes the delivery of health care services; educates providers and members on a proactive basis;… more
- Guthrie (Sayre, PA)
- …collaborates cooperatively with the patient and members of the interdisciplinary health care team. The Acute Case Manager takes a proactive approach to ... alternate levels of care . The Acute Case Manager also performs Utilization Management throughout the...interaction with the patient and family/caregivers, physician and other health care providers to achieve designated clinical,… more
- St. Luke's University Health Network (Bethlehem, PA)
- …the communities we serve, regardless of a patient's ability to pay for health care . The Care Manager Social Worker SCH is responsible for providing ... and community partners to address social determinants of health and promote self- management of care...SCH also collaborates with the Outpatient Care Manager RN, Care Management Outreach… more
- St. Luke's University Health Network (Bethlehem, PA)
- …serve, regardless of a patient's ability to pay for health care . The behavioral health care manager is a core member of the collaborative care ... care team or medical team. The behavioral health care manager is responsible...Group as requested. + Develop and complete relapse prevention self- management plan with patients who have achieved their treatment… more
- BAYADA Home Health Care (Blue Bell, PA)
- …the care provided by a multi-disciplinary team of home health care professionals. + Processing incoming referrals. + Management and mentoring of Clinical ... **BAYADA Home Health Care ** is currently seeking a...procedures. Clinical Managers are also accountable for internal case management , field staff evaluation and development. _Location: 512 Township… more
- Health Care Service Corporation (Philadelphia, PA)
- …+ Previous HEDIS and/or CMS STARs experience + Solid understanding of health insurance, customer messaging/design and project management + Expert level ... of providers, and for ongoing provider service. As a manager , this individual will lead a team of Network...for our clients. This person is responsible for the management , mentoring and training of a team responsible for… more
- CVS Health (Harrisburg, PA)
- … care experience for the member. + Meticulous documentation of care management activity in the member's electronic health record. + Collaborate with other ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading ...with heart, each and every day. **Job Summary** The Care Manager -Registered Nurse is a key member… more
- Highmark Health (Monroeville, PA)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Plans, directs, organizes and controls human resources materials and budget. ... Assures timely and accurate reports and records for patient care and healthcare operations in compliance with bylaws, policies, JC, DOH, and CMS regulations.… more
- St. Luke's University Health Network (Tamaqua, PA)
- … in the communities we serve, regardless of a patient's ability to pay for health care . The Manager , Practice Operations leads and manages the operations ... management experience including one year in a health care organization required. OR Master's Degree... management experience including one year in a health care organization required. OR associate degree… more
- Magellan Health Services (Morrisville, PA)
- …an appropriate and effective person-centered care plan, member education on health -related social needs, and care management . Entails coordination with ... Responsible for promoting integrated health practices through assessment, care planning...or case management . General Job Information Title Care Manager BH/RN, Remote in PA Grade… more