- Highmark Health (Harrisburg, PA)
- …and walkthroughs. + ** Utilization Management & Clinical Expertise:** + Utilization Management Knowledge : A strong understanding of utilization ... walkthroughs. + ** Utilization Management & Clinical Expertise:** + Utilization Management Knowledge : A strong understanding of utilization … more
- Guthrie (Sayre, PA)
- …approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of ... Bonus For Qualified RNs! Position Summary: The Acute Case Manager utilizes industry accepted processes for achieving optimal patient,...experience in an acute care setting with strong care management , utilization review, and payer knowledge… more
- WellSpan Health (Lebanon, PA)
- …**Duties and Responsibilities** + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for continued ... quality and cost of care efforts. + Liaisons between utilization management team, third party payers, and...Life Support Upon Hire Required + Certified in Case Management Preferred ** Knowledge , Skills, and Abilities:** +… more
- Magellan Health Services (Somerset, PA)
- …health care setting.* Strong organization, time management and communication skills.* Knowledge of utilization management procedures, mental health and ... an active work load in accordance with National Care Manager performance standards. + Works with community agencies as...Strong organization, time management and communication skills. Knowledge of utilization management procedures,… more
- St. Luke's University Health Network (Allentown, PA)
- …patient's ability to pay for health care. The IT Vendor and Contracts Manager leads IT's Vendor/Contact Management Office (VCMO). Responsibilities include but ... and attainment, reporting and governance. At an operational level, the Manager directs contract consultations and negotiations, including contract reviews, analysis,… more
- 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 ... care/treatment, The Joint Commission Standards, Federal/State regulations relative to utilization /case management , discharge planning, Medicare, Medicaid, and… more
- Penn Medicine (Philadelphia, PA)
- …+ Registered Nurse - PA (Required) + 5yrs prior experience as a Nurse Case Manager with knowledge of utilization review and 3rd Party Payors (Required) ... not limited to admissions, patient financial services, clinical resource management and provider medical staff and designees.Assist in preparation...And 5+ years Prior experience as a nurse case manager with knowledge of utilization … more
- CDR Maguire (Allentown, PA)
- …skills. + Proven strategic planning and business development experience. + Financial management knowledge and ability to review and interpret financial ... - As overseen by the PA Director of Construction Services and Construction Services Manager - PA East, provide Construction Management Support for PennDOT and PA… more
- Highmark Health (Pittsburgh, PA)
- …effective resource utilization . Serves as key team members in the management of readmissions, length of stay, ED utilization , and patient/family ... or CERTIFICATIONS** **Required** + None **Preferred** + ACM Certification (Accredited Case Manager ) - American Case Management Association - American Case … more
- UPMC (Hanover, PA)
- **$6,000 sign on bonus offered ** The Discharge Plan Manager functions as the coordinator and is accountable for all post-discharge needs and acts as financial ... and placing a focus on an optimal discharge plan with timely utilization of hospital resources. This optimal discharge plan reviews discipline recommendations and… more