• Utilization Review RN Case Manager

    Penn Medicine (Philadelphia, PA)
    …party payer requirementsEducates team in appropriate documentation to reflect Intensity of service (IS) / Severity of Illness (SI) and plan of careProactively ... for all patient days accurately in CanopyEnters review indicating "pending" status of case if outcome not determined and accounts for all cases assigned on a… more
    Penn Medicine (08/19/25)
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  • Bilingual Case Manager

    Cardinal Health (Harrisburg, PA)
    …better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of ... coordination of patient care and timely access to necessary services + Assist in obtaining insurance, prior authorization, and...in Spanish required + Previous Hub or Patient Support Service experience preferred + High School diploma or equivalent… more
    Cardinal Health (08/14/25)
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  • Social Work Case Manager - Full Time…

    Highmark Health (Erie, PA)
    …discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all ... the email below. For accommodation requests, please contact HR Services Online at ###@highmarkhealth.org California Consumer Privacy Act Employees, Contractors,… more
    Highmark Health (08/12/25)
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  • RN Case Manager - St. Mary Home Care

    Trinity Health (Newtown, PA)
    …Home Care has a full-time opening for a Primary Care Nurse for Home Care services for the Langhorne, Newtown, and greater Bucks County area. Signing Bonus is not ... speech therapy and medical social work), palliative care, hospice and bereavement services . Our legacy continues with a pioneering, future-thinking care model. We… more
    Trinity Health (08/15/25)
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  • Bilingual RN Case Manager - Mercy…

    Trinity Health (Philadelphia, PA)
    …speech therapy and medical social work), palliative care, hospice and bereavement services . Our legacy continues with a pioneering, future-thinking care model. We ... race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or… more
    Trinity Health (07/22/25)
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  • Case Management Nurse-RN Weekend Option 3…

    WellSpan Health (York, PA)
    …health care. Works in a team type assignment or Care Coordination Team (CCT) Model ( Case Manager and Social Worker teams are assigned to patients by physician ... pm **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of resources to… more
    WellSpan Health (08/19/25)
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  • Clinical Care Manager (RN) - Munhall…

    UPMC (Munhall, PA)
    …Insurance + Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Certified Case Manager (CCM) + Driver's License + Registered Nurse (RN) + ... determined based upon education and nursing experience for Sr. Professional Care Manager within the Insurance Services Division. **Responsibilities:** + Assist… more
    UPMC (08/22/25)
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  • Associate Manager Clinical Health…

    CVS Health (Pittsburgh, PA)
    …experience within a managed care organization + Behavioral Health Experience + Certified Case Manager (CCM) + Proficiency with learning and navigating care ... members' health care and social determinant needs. The Associate Manager , Clinical Health Services will be accountable...strong leadership skillset to lead a dynamic team of case managers with proven experience in change management. We… more
    CVS Health (08/20/25)
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  • Operations Manager , VBCM- Remote

    Sharecare (Harrisburg, PA)
    …years' experience in Care/ Case Management + NCQA experience preferred + Certified Case Manager preferred + Prior management and supervision of a clinical ... **Job Description:** **Job Summary:** The VBCM Operations Manager will report to the Director of Clinical...variety of areas such as integration activities, audits, and case management in collaboration with the Director. + Provide… more
    Sharecare (07/30/25)
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  • RN Care Manager

    Trinity Health (Philadelphia, PA)
    …**Licensure/Certification:** + Active **PA RN License** required. + **Preferred Certifications:** + Certified Case Manager (CCM) + Accredited Case Manager ... **Employment Type:** Full time **Shift:** **Description:** **RN Care Manager ** **Location:** Nazareth Hospital **Department:** Coordinated Care **Schedule:**… more
    Trinity Health (08/13/25)
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