- CVS Health (Chester Springs, PA)
- …and keyboarding + Bachelor's degree + Discharge planning or home health care with Medicare members + Certified Case Manager or Additional national ... network management, clinical coverage, and policies. **Position Summary/Mission** Community Care Case Manager use a collaborative process of assessment,… more
- UPMC (Washington, PA)
- …to develop performance improvement activities as indicated. + Oversees daily operations of the Case Manager (CM) staff under the direction of the Director. + ... **Purpose:** The Manager oversees the day-to-day operations of the Case management department under the direction of the Director. The Manager is accountable… more
- CVS Health (Harrisburg, PA)
- …comprised of network management, clinical coverage, and policies. The Community Care Case Manager use a collaborative process of assessment, planning, ... CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members. - 2 years Case Management,...skills including navigating multiple systems and keyboarding - Certified Case Manager is preferred. - Additional national… more
- WellSpan Health (Lebanon, PA)
- …period **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of resources to ... discharge needs. Provides leadership in the integration of utilization and case management principles. **Duties and Responsibilities** + Reviews assigned patients… more
- WellSpan Health (Ephrata, PA)
- …matrix reporting to hospital leadership, supervises and oversees the work activities of Case Management at specified entity. Works in a team leadership model to ... Hospital, System and community needs. Provides direction to staff regarding case management, discharge planning, social services and utilization management. Provides… more
- Cardinal Health (Harrisburg, PA)
- …get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through patient ... about long and short-range changes in the reimbursement environment including Medicare , Medicaid, Managed Care, and Commercial medical and pharmacy plans while… more
- Highmark Health (Pittsburgh, PA)
- …**Job Description :** Date Posted: 20250226 Location: Allegheny General Hospital Department: Case Management, Inpatient Status: Full Time Shift: 80 hours every two ... Daylight M-F, 40 hours per week, rotating weekends and holidays Union: Yes ** CASE MANAGEMENT:** The Case Management Department at Allegheny General Hospital… more
- St. Luke's University Health Network (Bethlehem, PA)
- …continued stay reviews, retro authorizations and other coverage related efforts. The Case Manager actively explores and utilizes available internal and external ... and interventions according to hospital policy and other regulatory guidelines (ie Medicare , CARF, JCAHO, etc.). Documentation is completed in a progressional and… more
- Cardinal Health (Harrisburg, PA)
- …about long and short-range changes in the reimbursement environment including Medicare , Medicaid, Managed Care, and Commercial medical and pharmacy plans while ... experience preferred + High School diploma or equivalent preferred + Knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for… more
- Cardinal Health (Harrisburg, PA)
- …benefit investigations, prior authorizations, and appeals, preferred + Knowledge of Medicare , Medicaid and Commercially insured payer common practices and policies, ... preferred + Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred + Knowledge of ICD9/ICD10 coding is preferred + Critical and creative thinking, preferred + Important to have a strong attention to detail **TRAINING AND WORK… more
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