- 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
- CenterWell (Harrisburg, PA)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… 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… more
- Genesis Healthcare (York, PA)
- …Five to seven years of clinical nursing experience is required. Prior experience in utilization review , case management or discharge planning is required. ... while making a meaningful impact in the communities we serve. Responsibilities The Manager , Case Management is responsible for the clinical, administrative, 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 review… 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
- UPMC (Pittsburgh, PA)
- …of health insurance experience required. + 1 year of experience in clinical, utilization management , home care, discharge planning, and/or case management ... by the interdisciplinary team summarizing clinical and social history, healthcare resource utilization , case management interventions. Update the plan of care… 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
- Healthfirst (PA)
- The Case Manager , Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review , discharge ... planning, and case management as assigned. The Case Manager , Utilization Management is also responsible for efficient utilization of health services… more
- Highmark Health (Harrisburg, PA)
- …including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and ... utilization . Serves as key team members in the management of readmissions, length of stay, ED utilization...**Required** + None **Preferred** + ACM Certification (Accredited Case Manager ) - American Case Management Association -… more