• Director Utilization Mgmt (Do Or MD…

    Wellpath (Lemoyne, PA)
    …Director of Utilization Management leads and oversees utilization review, case management , quality improvement, and related policy and practice initiatives ... the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and stakeholders, and… more
    Wellpath (08/08/25)
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  • LPN Utilization Mgmt Reviewer - Medical…

    Guthrie (Troy, PA)
    Up to a $15,000.00 Sign on Bonus! Summary The LPN Utilization Management (UM) Reviewer, in collaboration with Care Coordination, Guthrie Clinic offices, other ... Business Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of prior authorization/certification for reimbursement… more
    Guthrie (07/15/25)
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  • RN Acute Case Manager - System Care…

    Guthrie (Troy, PA)
    …care setting with strong care management , utilization review, and payer knowledge. A Case Management certification or obtaining a Case Management ... case reimbursement. a) Identifies cost/clinical outlier patients for intensive case management and facilitates evaluation of alternative care options. b)… more
    Guthrie (07/29/25)
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  • Case Management Manager - UPMC

    UPMC (Washington, PA)
    The Manager oversees the day-to-day operations of the Case management department under the direction of the Director. The Manager is accountable for the ... following Case Management functions: training, auditing, systems support: Case Management Technology, InterQual, Concurrent Denials and reporting. Leads… more
    UPMC (07/11/25)
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  • Clinical Reimbursement Case

    Genesis Healthcare (York, PA)
    …a meaningful impact in the communities we serve. Responsibilities The Manager, Case Management is responsible for the clinical, administrative, and financial ... of its payor customers. The Manager will also perform the functions of the Case Management Job Description and will be measured based on case management more
    Genesis Healthcare (07/01/25)
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  • Case Management Nurse-RN Weekend…

    WellSpan Health (York, PA)
    …per year **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of resources ... care transition needs. Provides leadership in the integration of utilization and case management principles throughout the hospital. **Essential Functions:** +… more
    WellSpan Health (07/22/25)
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  • Registered Nurse - Case Management

    Prime Healthcare (Bristol, PA)
    …Five years acute care nursing experience preferred. At least one year experience in case management , discharge planning or nursing management , preferred. + ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/219331/registered-nurse case - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityLower… more
    Prime Healthcare (08/08/25)
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  • Analyst, Case Management (Remote)

    CVS Health (Harrisburg, PA)
    …promote lifestyle changes for optimal health. + **Monitoring and Documentation:** Adhere to case management and quality management processes in compliance ... dedicated workspace to fulfill job requirements effectively. **Preferred Qualifications** + Case Management and Discharge Planning Experience + Managed Care… more
    CVS Health (08/01/25)
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  • Case Management Specialist

    Community Health Systems (Scranton, PA)
    …a related field preferred + 1-2 years of experience in care coordination, case management support, patient access, or healthcare administration required + ... **Job Summary** The Care Management Specialist provides administrative and operational support to the Care Management team, assisting with care coordination,… more
    Community Health Systems (08/08/25)
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  • Anti-Trafficking Case Manager

    The Salvation Army (Philadelphia, PA)
    …The Anti-Trafficking Case Manager will provide client-centered, trauma-informed, clinical case management to survivors of commercial sexual exploitation and ... The anti-trafficking Case Manager will provide comprehensive, wrap around case management services for women experiencing behavioral health needs and… more
    The Salvation Army (07/12/25)
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