• RN Acute Case Manager - System Care

    Guthrie (Sayre, PA)
    …five (5) years of experience in an acute care setting with strong care management, utilization review , and payer knowledge. A Case Management ... for alternate levels of care . The Acute Case Manager also performs Utilization Management throughout the continuum of care in collaboration… more
    Guthrie (07/17/25)
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  • Clinical Care Manager (RN) - Erie

    UPMC (Pittsburgh, PA)
    …healthcare resource utilization , case management interventions. Update the plan of care following review and communicate recommendations to the member and ... for? UPMC Health Plan is hiring a full-time Clinical Care Manager to support our partnership with... provider that promotes healthy lifestyles, closes gaps in care , and reduces unnecessary ER utilization and… more
    UPMC (09/10/25)
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  • Professional Care Manager

    UPMC (Pittsburgh, PA)
    UPMC Health Plan is seeking a full-time Professional Care Manager , Supervisor to join our Utilization Management (UM) Clinical Operations team. This position ... The Supervisor is responsible for oversight and day-to -day care coordination functions for telephonic, clinical, or utilization...years of nursing experience required + 4 years of care manager experience required + Prior UM… more
    UPMC (10/14/25)
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  • Telephonic Care Manager (RN)…

    UPMC (Pittsburgh, PA)
    …healthcare resource utilization , case management interventions. Update the plan of care following review and communicate recommendations to the member and ... UPMC Health Plan is hiring a full-time Pediatric Telephonic Care Manager to support the Medical Management... provider that promotes healthy lifestyles, closes gaps in care , and reduces unnecessary ER utilization and… more
    UPMC (10/14/25)
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  • Acute Care Manager (RN)

    ChenMed (Philadelphia, PA)
    …assigned hospital daily from 9am-3pm, working remote for the remaining hours. The Acute Care Manager , Complex Care (RN) is responsible for achieving positive ... Management/Disease Management program with verbal introduction to their Community Care Manager for home visit once discharge...patients' progress and adjust and plan accordingly + Understanding utilization review and how to leverage with… more
    ChenMed (07/25/25)
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  • Care Experience Manager

    Aveanna Healthcare (Bala Cynwyd, PA)
    Care Experience Manager ApplyRefer a FriendBack Job Details Requisition #: 208219 Location: Bala Cynwyd, PA 19004 Category: Administrative/Clerical Salary: ... health and wellbeing of clients and their families. The Care Experience Manager (CEM) is accountable for...clinician, and within insurance authorization. - Responsible to manage utilization of direct care team members based… more
    Aveanna Healthcare (10/02/25)
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  • Care Manager Associate (Hybrid)…

    UPMC (Pittsburgh, PA)
    The Care Manager Associate (CMA) position will be part of the UPMC Health Plan's Community Services Community Paramedic Team. The team expands paramedic roles ... the CMA's collaborations, practical comprehension and hands-on experience in clinical care / utilization management will result by collecting and assisting with… more
    UPMC (09/17/25)
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  • Manager , Clinical Care Coordination…

    UPMC (York, PA)
    …required.KNOWLEDGE AND SKILLS:Expertise in care management, discharge planning and utilization review processes. Ability to build credible and effective ... UPMC is hiring a Manager , Clinical Care Coordination and Discharge for our hospital in York! This is a full time, day shift position with NO weekends and NO… more
    UPMC (09/19/25)
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  • Professional Care Manager

    UPMC (Pittsburgh, PA)
    …UPMC Children's Hospital has fulfilled this mission since its founding in 1890. The Care Manager (CM) coordinates the clinical and financial plan for patients. ... utilization management, resource management, discharge planning and post-acute care referrals and authorizations. Works with multi-disciplinary team in resource… more
    UPMC (09/17/25)
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  • Ambulatory Care Manager MSW (Full…

    Penn Medicine (Lancaster, PA)
    …have valid driver's license and daily access to an insured vehicle. + Knowledge of Utilization review or managed care + Licensure with Commission for Case ... members experiencing housing insecurity and those currently experiencing homelessness. The Ambulatory Care Manager should be self driven and adaptable, working… more
    Penn Medicine (09/12/25)
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