• UM Care Manager (RN) - Flex FT

    UPMC (Pittsburgh, PA)
    …to candidates with a Pennsylvania RN license. The Utilization Management (UM) Care Manager is responsible for utilization review of health plan services ... Health Plan is hiring a flex full-time UM Care Manager to support our UM Clinical Operations team. This...appropriate setting and cost - effective manner. **Responsibilities:** + Review and document clinical information from health care providers… more
    UPMC (08/08/25)
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  • RN Pre Certification Case Manager

    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) ... Experience: * And 5+ years Prior experience as a nurse case manager with knowledge of utilization review and third-party payors. We believe that the best… more
    Penn Medicine (08/07/25)
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  • Medical Director Utilization Management

    AmeriHealth Caritas (Philadelphia, PA)
    …provides organizational leadership in the operational areas of care management, utilization review , appeals, quality improvement and related policy and ... practice initiatives in collaboration with the Corporate Medical Director(s), Utilization Management and the Vice President, Medical Affairs. ;The following… more
    AmeriHealth Caritas (08/12/25)
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  • Utilization Management Nurse

    CenterWell (Harrisburg, PA)
    …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work… more
    CenterWell (08/08/25)
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  • Utilization Management Nurse

    CenterWell (Harrisburg, PA)
    …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to… more
    CenterWell (08/02/25)
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  • RN Acute Case Manager - Medical Social…

    Guthrie (Troy, PA)
    …years of experience in an acute care setting with strong care management, utilization review , and payer knowledge. A Case Management certification or obtaining ... recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care in collaboration with… more
    Guthrie (08/08/25)
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  • Construction Services Project Manager

    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 ... as overseen by the PA Director of Construction Services and Construction Services Manager - PA East: + Promote excellent internal and external client service… more
    CDR Maguire (08/08/25)
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  • Clinical Care Manager (RN) - Shadyside

    UPMC (Pittsburgh, PA)
    …you are caring for? UPMC Health Plan is hiring a full-time Clinical Care Manager to support our partnership with various physician practices. This role will support ... the Aiken Ave Employee Garage. As a Clinical Care Manager , you will be responsible for care coordination and...lifestyles, closes gaps in care, and reduces unnecessary ER utilization and hospital readmissions. Coordinate and modify the care… more
    UPMC (07/19/25)
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  • RN Clinical Manager

    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
    CenterWell (06/17/25)
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  • Assistant District Forester (Forest Assistant…

    Commonwealth of Pennsylvania (PA)
    Assistant District Forester (Forest Assistant Manager ) - Clear Creek Forest District Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5009219) ... Apply  Assistant District Forester (Forest Assistant Manager ) - Clear Creek Forest District Salary $67,736.00 - $102,905.00 Annually Location Multi-County, PA Job… more
    Commonwealth of Pennsylvania (07/30/25)
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