• Denials Management Specialist, Registered Nurse…

    St. Luke's University Health Network (Allentown, PA)
    …Work Queues for Medical Necessity and Late-Pick-Up/Notification that are entered by Case Management and Business Office. + Monitors retro denials to ensure ... eg no appeal, appeal level and final decision with revenue impact. + Assists Case Management as necessary to ensure that documentation is entered and transmitted to… more
    St. Luke's University Health Network (08/19/25)
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  • Associate Clinical Coordinator

    J&J Family of Companies (West Chester, PA)
    …service and suppliers, to develop improved methods of communication and case tracking, leading to enhanced productivity and overall efficiency. The coordinator ... and timely updates to tracking sheets and / or case management software, as well as filing of all...MS Office Suite (Word, Excel, PowerPoint, etc.) is required. ** Preferred :** + Experience in project management, customer service or… more
    J&J Family of Companies (08/12/25)
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  • AML Consultant

    Deloitte (Pittsburgh, PA)
    …in these Lookback engagements, you will likely be involved in: + Performing case investigations + Assessing potential AML and sanctions risks as they arise ... throughout case investigations. + Making recommended decisions regarding ...you do and the clients and industries/sectors you serve Preferred + Investigations Experience + FIU - Financial Institutions… more
    Deloitte (06/15/25)
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  • Licensed Professional Care Manager (Camp Hill, PA)

    UPMC (Camp Hill, PA)
    …the practice of held licensure. + Demonstrates knowledge of clinical treatment, case management and community resources. + Encourages coordination of care with ... and recommendations for improvement. + Assumes responsibility for a designated client case load across the continuum. + Provides members, providers, and other… more
    UPMC (08/20/25)
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  • Lead Pharmacovigilance QC Specialist

    United Therapeutics (Harrisburg, PA)
    …a SME on evaluating and ensuring appropriate quality standards and adherence to case processing procedures. You are passionate about PV and enjoy partnering with ... The Lead Pharmacovigilance QC Specialist provides strategic oversight of end-to-end case safety quality, ensuring compliance, and quality in adverse effects,… more
    United Therapeutics (08/21/25)
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  • Medical Director Utilization Management

    AmeriHealth Caritas (Philadelphia, PA)
    …policies and procedures adhere to contractual obligations. + Performs clinical case reviews in conjunction with Medical Excellence Department. + Demonstrates ... + Assists IHCM Managers in assessing members' need for case management services + Attends case management...within 30 days of hire.; + Current Pennsylvania license preferred , must be willing to be obtain additional licenses… more
    AmeriHealth Caritas (08/12/25)
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  • Manager Technology Development

    PPL Corporation (Allentown, PA)
    …remotely, or a combination of both. Assigned work location may change. In the case of remote work, physical presence in the office/on-site may be required to engage ... remotely, or a combination of both. Assigned work location may change. In the case of remote work, physical presence in the office/on-site may be required to engage… more
    PPL Corporation (07/22/25)
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  • Veteran Housing Service Coordinator (SSVF…

    Veterans Leadership Program (Pittsburgh, PA)
    …VLP is a team comprised of experienced leadership, support staff, and case managers including Veterans, National Guard, Army Reserve, family members of Veterans, ... for Veteran Families (SSVF) program, provides comprehensive outreach and case management services to Veterans and their households in...Social Work or Social Science or equivalent experience is preferred . + Minimum of three (3) to five (5)… more
    Veterans Leadership Program (07/11/25)
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  • Medication Therapy Management Specialist

    Prime Therapeutics (Harrisburg, PA)
    …in Excel, Word, and system operations (eg workflow processes and case management) + Government programs (Medicare) knowledge ** Preferred Qualifications** ... + Contact Center experience + Pharmacy and/or PBM experience + 1 year of experience in healthcare industry + Experience working with highly confidential medical information + CPhT certification + Fluency in another language (Spanish) Every employee must… more
    Prime Therapeutics (08/27/25)
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  • Social Services Aide

    Donnelly-Boland and Associates (Beaver Falls, PA)
    Job Summary: The Social Services Aide supports social workers and case managers in delivering services to individuals and families in need. Responsibilities include ... assisting with case management, providing administrative support, helping clients access community...degree in social work, psychology, or a related field preferred ) + Previous experience in social services, human services,… more
    Donnelly-Boland and Associates (08/28/25)
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