- Trinity Health (Springfield, PA)
- …satisfaction, strategic goals and regulatory compliance. **MINIMUM QUALIFICATIONS** + Registered Nurse /Therapist with current license from respective State ... Full time **Shift:** **Description:** Mercy Home Health is seeking a Quality Management Specialist- RN in Langhorne, PA. area for a Hybrid position. Must live locally… more
- UPMC (Pittsburgh, PA)
- …Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Certified Case Manager (CCM) + Driver's License + Registered Nurse ( RN ) + Act 33 with renewal + Act 34 ... case management? Do you have an interest in health insurance , but thrive on working in a medical office...other health plan and system departments as appropriate. + Review member's current medication profile; identify issues related to… more
- Select Medical (Hummelstown, PA)
- …and valid state licensure or eligibility for state licensure as a Registered Nurse , Physical Therapist, Occupational Therapist, or Speech Language Pathologist ... Select Medical and Penn State Health Hummelstown, PA **Clinical Assessment Specialist ( RN , PT, OT, SLP)** **Full-Time** The Clinical Assessment Specialist is a… more
- UPMC (Pittsburgh, PA)
- …UPMC office location daily. **Licensure, Certifications, and Clearances:** + CCM is a bonus. + Registered Nurse ( RN ) + Act 34 *Current licensure either in ... Are you an experienced Pediatric nurse with case management experience? We have a...nursing experience for Sr. Professional Care Manager within the Insurance Services Division. **Responsibilities:** + Present complex members for… more
- Highmark Health (Monroeville, PA)
- …also building relationships across the organization in a community setting. **GENERAL OVERVIEW:** Registered nurse who is proficient in the coordination of care ... outcomes. Interviews and collects patient specified data and chart review related to readmission. + Knowledgeable of and complies...a clinical nursing role + Current State of PA RN licensure OR Current multi-state licensure through the enhanced… more
- Penn Medicine (Philadelphia, PA)
- …as example.Ensures compliance with all JCAHO regulations. Credentials: + BSN (Required) + Registered Nurse - PA (Required) + 5yrs prior experience as a ... each day. Are you living your life's work? Job Title: RN Pre Certification Case Manager Department: Business Operations -... Nurse Case Manager with knowledge of utilization … more
- Highmark Health (Pittsburgh, PA)
- …through the enhanced Nurse Licensure Compact (eNLC). + 5 years as a Registered Nurse + CPR Certification, current incumbents in the role as of 1/1/2023 ... health assessment, appropriate department testing and follow-up, lab work review , vaccine updates and drug testing. (40%) + Coordinates...Certificate + Current State of PA RN licensure OR Current multi-state licensure… more
- Highmark Health (Jefferson Hills, PA)
- …and/or education as determined by the company in lieu of bachelor's degree. + Registered Nurse License required. + Bachelors of Science in Nursing required if ... the revenue cycle process. + Provides primary (or secondary) review of reconciliation of monies being collected and deposited....in an Oncology setting. + Knowledge of medical terminology, insurance theory and ICD-9, and CPT coding required. +… more
- LifePoint Health (Roaring Spring, PA)
- …career advancement opportunities. *What we're looking for * Applicants must haveGraduate of a RN program and a current nurse 's license in the state of ... can provide exceptional care to others. As a part-time RN - OR joining our team, you're embracing a...within legal standards of practice. * Participate in quality review and performance improvement projects. * Use problem-solving and… more
- Highmark Health (Monroeville, PA)
- …but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and limitations, ... degree + 3 years in a clinical nursing role + Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact… more