- CenterWell (Harrisburg, PA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Trinity Health (Langhorne, PA)
- …consumption, and acceptable clinical outcomes, through integration and implementation of utilization management . **Minimum Requirements:** + Bachelor's degree in ... related to the clinical review and level of care. Management of all review and appeals utilizing a modified...PA RN License required. + CCM or Accredited Case Manager certification preferred. + Previous experience in 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
- WellSpan Health (Lewisburg, PA)
- …principles. **Essential Functions:** + 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
- 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
- Highmark Health (Monroeville, PA)
- …communication skills + Advanced Excel experience + Strong analytical skills + Budget Management + Robust problem solving + Thorough knowledge of automated supply ... for the strategic implementation of supply chain initiatives and operational management throughout AHN hospitals and surgery centers. The Materials Manager… more
- Penn Medicine (Philadelphia, PA)
- …ensure lowest price paid. + Works to identify opportunities for standardization and utilization management within a product categories and potential to leverage ... each day. Are you living your life's work? **Contract Manager Corporate Supply Chain** Job Summary: + The Contract... leads vendor negotiations, supports Value Analysis and has knowledge of contract to ensure compliance with all hospital,… more
- Highmark Health (Monroeville, 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
- Penn Medicine (Lancaster, PA)
- … management platform/analytics. + Analyzes data to identify under/over utilization ; improve resource consumption; promotes potential reduction in cost and ... valid driver's license and daily access to an insured vehicle. Preferred Qualifications + Knowledge of Utilization review or managed care + Experience with home… more