- WellSpan Health (York, 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... of resources to the attention of the appropriate manager (s). **Common Expectations:** + Demonstrates a commitment to patient,… more
- Genesis Healthcare (York, PA)
- …while making a meaningful impact in the communities we serve. Responsibilities The Manager , Case Management is responsible for the clinical, administrative, and ... responding to the needs of its payor customers. The Manager will also perform the functions of the Case...of clinical nursing experience is required. Prior experience in utilization review, case management or discharge planning… more
- CVS Health (Harrisburg, PA)
- …with heart, each and every day. We are seeking a proactive and highly organized Manager of Production Management to join the Signify Health team to oversee field ... based on service territory and capacity constraints + System Utilization & Workflow Management + Operate and maintain Salesforce Field Service to manage… 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
- Magellan Health Services (Somerset, PA)
- …Strong organization, time management and communication skills.* Knowledge of utilization management procedures, mental health and substance abuse community ... an active work load in accordance with National Care Manager performance standards. + Works with community agencies as...time management and communication skills. Knowledge of utilization management procedures, mental health and substance… 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 review and… more
- CDR Maguire (Allentown, PA)
- …- As overseen by the PA Director of Construction Services and Construction Services Manager - PA East, provide Construction Management Support for PennDOT and PA ... Preferred- Professional Engineer in Pennsylvania for Civil Engineering (PE); Project Management Professional (PMP); Certified Construction Manager (CCM). +… 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
- Commonwealth of Pennsylvania (PA)
- …term, long term, and strategic work plans to meet organizational and forest resource management goals, including the utilization and management of funds ... term, long term, and strategic work plans to meet organizational and forest resource management goals, including the utilization and management of funds… more