- Highmark Health (Monroeville, PA)
- …advisor and third party payers. + Maintains a working knowledge of care management , care coordination changes, utilization review changes, authorization ... as an educational resource to all AHN staff regarding utilization review practice and governmental commercial payer...**Required** + None **Preferred** + ACM Certification (Accredited Case Manager ) - American Case Management Association -… more
- CenterWell (Lancaster, PA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... at our Lancaster, PA branch location.** The **RN Clinical Manager ** coordinates and oversees all direct care patient services...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… more
- ChenMed (Philadelphia, PA)
- …years' clinical work experience required + A minimum of one (1) year of utilization review and/or case management , home health, hospital discharge planning ... working remote for the remaining hours. The Acute Care Manager , Complex Care (RN) is responsible for achieving positive...patients' progress and adjust and plan accordingly + Understanding utilization review and how to leverage with… more
- Penn Medicine (Lancaster, PA)
- …license and daily access to an insured vehicle. Preferred Qualifications + Knowledge of Utilization review or managed care + Experience with home visits + ... management platform/analytics. + Analyzes data to identify under/over utilization ; improve resource consumption; promotes potential reduction in cost and… more
- Burns & McDonnell (Conshohocken, PA)
- …, Program Manager as well as internal and external executive management as required. + Collaborate with engineering team to establish the development and ... **Description** The Construction Project Manager supports the Engineer Procure Construct (EPC) Project Manager or Program Manager to oversee day-to-day… more
- Geisinger (Lewistown, PA)
- …and efficiency results for assigned population. + Works to appropriately apply benefits and utilization management serving as a resource to the patient or member ... as part of a shared rotation. Don't worry, we'll review this in your interview. At least two (2)...have prior RN experience in a hospital setting. Case Management experience is preferred and not required. The successful… more
- Amergis (Pittsburgh, PA)
- …and referrals for psychosocial needs + Participates in Quality Assurance and Utilization Review activities, as directed + Empowers patients in decision-making ... The RN Case Manager is responsible for coordinating continuum of care...of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical… more
- Republic Services (Scottdale, PA)
- …and monitor all required testing, including sampling of monitoring wells; monitors utilization of cover material; review soil reports and provide information ... **POSITION SUMMARY:** Within a business unit, the Operations Manager - Landfill manages the landfill operations to ensure all activities are in compliance with… more
- CVS Health (Harrisburg, PA)
- …Qualifications** + Crisis intervention skills preferred Managed care/ utilization review experience preferred + Case management and discharge planning ... experience preferred + Managed care/ utilization review experience preferred **Education** Masters Degree in Social Work or Counseling required **Anticipated… more
- Burns & McDonnell (Conshohocken, PA)
- **Description** The Construction Project Manager supports the Engineer Procure Construct (EPC) Project Manager to oversee day-to-day operations from ... through project completion and warranty periods. The Construction Project Manager is responsible for managing the construction project safety, quality,… more
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