- Highmark Health (Monroeville, PA)
- …including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and ... outcomes, engages patients/caregivers in their healthcare, and supports effective resource utilization . Serves as key team members in the management of readmissions,… 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 and… more
- Highmark Health (Monroeville, PA)
- …Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory ... etc. Serves as an educational resource to all AHN staff regarding utilization review practice and governmental commercial payer guidelines. Adheres to… more
- WM (Philadelphia, PA)
- …responsible for delivering industry leading maintenance performance and asset utilization . Responsible for delivering excellence in cost, equipment availability, ... asset utilization , shop productivity management and performance improvements and fleet...to encourage safe and efficient operations. Meet all financial review dates and corporate directed programs in a timely… more
- ChenMed (Philadelphia, PA)
- …assess and record patients' progress and adjust and plan accordingly + Understanding utilization review and how to leverage with inpatient staff for possible ... working remote for the remaining hours. The Acute Care Manager , Complex Care (RN) is responsible for achieving positive...required + A minimum of one (1) year of utilization review and/or case management, home health,… more
- Geisinger (Wilkes-Barre, PA)
- …As one of the Top 8 Most Innovative Healthcare Systems in Becker's Hospital Review , we're working to create a national model for improving health. Today, we're ... career with impact. Join us as an RN Case Manager in Care Coordination to strengthen that impact. Apply...of optimizing the patient or member's health status. Manages utilization and practice metrics to further refine the delivery… more
- Genesis Healthcare (York, PA)
- …to seven years of clinical nursing experience is required. Prior experience in utilization review , case management or discharge planning is required. Prior ... making a meaningful impact in the communities we serve. Responsibilities The Manager , Case Management is responsible for the clinical, administrative, and financial… more
- Highmark Health (Harrisburg, PA)
- …pharmacy strategies and other pharmacy strategy teams to execute on the formulary/ utilization (UM) and other strategic pharmacy products. This job will be ... with the goal of lowering care costs associated with the Organization's drug utilization across both the pharmacy as well as the medical benefits. This job… more
- Burns & McDonnell (Conshohocken, PA)
- **Description** The Construction Project Manager supports the Engineer Procure Construct (EPC) Project Manager or Program Manager to oversee day-to-day ... through project completion and warranty periods. The Construction Project Manager is responsible for managing the construction project safety, quality,… more
- Penn Medicine (Lancaster, PA)
- …Pennsylvania Board of Nursing. + Bachelor's degree in Nursing BSN . + Knowledge of utilization review or managed care. + Care management experience in a managed ... _Penn Medicine Lancaster General Health is recruiting for a full-time inpatient Case Manager to join a team of dedicated Case Managers managing a variety complex… more