• Case Manager

    BriteLife Recovery (Hanover, PA)
    …healthcare providers, community resources, and family members. + Documenting all case management service notes, assessments, reassessments, referrals and ... CASE MANAGER Do you work for a company...lifestyles and healthy choices. Under the supervision of the Director of Clinical Services, and in collaboration with a… more
    BriteLife Recovery (07/09/25)
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  • Medical Director - Medicare Appeals

    CVS Health (Harrisburg, PA)
    …provide clinical, coding, and reimbursement expertise as well as directing case management when necessary. The Medical Director will act as a business and ... Pediatrics (Med / Peds) Board Certification. In the Medical Director role, you will provide oversight for medical policy...eg, Clinical Practice and Health Care Industry. *Prior UM ( Utilization Management ) experience *Active and current state… more
    CVS Health (08/08/25)
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  • Medical Director - CVS Health Product,…

    CVS Health (Harrisburg, PA)
    …well as sales and account management . Duties include support for - case management , clinical content research & development, chronic condition management ... experience in health care delivery (clinical practice) Experience in managed care, care management , utilization management , quality management , or… more
    CVS Health (08/08/25)
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  • Unit Director - T11 Trauma

    UPMC (Altoona, PA)
    …have an amazing team of Nurses, Nursing Assistants, Physical Therapists, Physicians, and Case Management , who collaborate to provide exceptional patient care to ... Registered Nurse with leadership experience for an exciting opportunity as a Unit Director for our T11 Trauma unit!** In this challenging and rewarding position, the… more
    UPMC (05/23/25)
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  • Medical Director , Clinical Services

    Highmark Health (Harrisburg, PA)
    …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more
    Highmark Health (07/29/25)
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  • Medical Director - Spine

    CVS Health (Pittsburgh, PA)
    …and consistent responses to members and providers. Leads all aspects of utilization review/quality assurance, directing case management Provides clinical ... the US.** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home. The Medical Director more
    CVS Health (08/08/25)
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  • Registered Nurse Case Manager, Full Time,…

    St. Luke's University Health Network (Stroudsburg, PA)
    management , including but not limited to: Social workers, assistants, coordinators, utilization management staff, and director . + Facilitates ... for Warren Campus. Advanced degree preferred. BSN preferred, MSN and/or Case Management Certification preferred. TRAINING AND EXPERIENCE: Extensive clinical… more
    St. Luke's University Health Network (06/07/25)
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  • Principal Scientist/ Director - Outcomes…

    Merck (North Wales, PA)
    **Job Description** Under the guidance of a senior leader, the Principal Scientist ( Director ), Outcomes Research-Women's Cancer will be a member of the overall team ... characterize disease burden and epidemiology, treatment patterns, healthcare resource utilization and costs, physician and patient satisfaction surveys, clinical and… more
    Merck (08/08/25)
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  • Physician Advisor - Allegheny Health Network

    Highmark Health (Pittsburgh, PA)
    …leadership team. The Physician Advisor is an integral part of the Utilization Management Committee and participates in hospital and enterprise-level quality ... Physician Advisor works in concert with the admitting physician, Case Management , and other hospital personnel, to...appeal letters and participates in data collection activities for utilization management . + Receives daily report from… more
    Highmark Health (06/19/25)
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  • Occupational Therapist (OT) - Mobile Outpatient

    Genesis Healthcare (Williamsport, PA)
    …of the rehabilitation department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient ... of the rehab department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient identification… more
    Genesis Healthcare (08/08/25)
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