- Geisinger (Lewistown, PA)
- …of experience to build a rewarding, lasting career with impact. Job Duties The RN Complex Case Manager will work with individuals who have complex health ... quality and efficiency in the delivery of healthcare for complex care patient population. + Complex care...and available resources + Maintains required documentation for all case management activities. + Collects required data and utilizes… more
- Highmark Health (Harrisburg, PA)
- …the appropriate clinical interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are enrolled in case ... management. The incumbent conducts outreach to members enrolled in case management including but is not limited to: developing a care plan, encouraging behavior… more
- Penn Medicine (Lancaster, PA)
- …is recruiting for a full-time inpatient Case Manager to join a team of dedicated Case Managers managing a variety complex cases. Case Managers on the ... complex team take cases referred from our unit based Case Managers._ _The Complex Team manages cases for patients who have a variety of challenges and… more
- UPMC (Pittsburgh, PA)
- …obtained from interaction with members and providers. + Present or contribute to complex case reviews by the interdisciplinary team summarizing clinical and ... use your nursing background in outpatient, home health, or case management? Do you have an interest in health...Medication Review as appropriate. + Refer members to appropriate case management, health management, or lifestyle programs based on… more
- UPMC (Pittsburgh, PA)
- …obtained from interaction with members and providers. Presents or contributes to complex case reviews by the interdisciplinary team, summarizing clinical and ... history, current medications, geriatric syndromes, healthcare resource utilization, and case management interventions. Updates the plan of care following review… more
- St. Luke's University Health Network (Allentown, PA)
- … resolution, and impact on revenue and trending. + Coordinates RAC appeals for complex case reviews for medical necessity, including determining if appeal is ... Work Queues for Medical Necessity and Late-Pick-Up/Notification that are entered by Case Management and Business Office. + Monitors retro denials to ensure… more
- Humana (Harrisburg, PA)
- …metrics + Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health + The ... and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or… more
- Humana (Harrisburg, PA)
- …metrics. + Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health. + The ... background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data… more
- Humana (Harrisburg, PA)
- …metrics. + Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health. + The ... background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data… more
- Sharecare (Harrisburg, PA)
- …of their members to ensure successful completion of member goals, while providing Complex Case Management and/or care management support through the duration of ... program in an appropriate and efficient manner by providing high-quality telephonic Case or Care Management with CareFirst members. The Care Manager partners with… more