- WellSpan Health (York, PA)
- …**General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of resources to ... discharge needs. Provides leadership in the integration of utilization and case management principles. **Essential Functions:** + Reviews assigned patients for… more
- WellSpan Health (York, PA)
- …pm **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of resources to ... care. Works in a team type assignment or Care Coordination Team (CCT) Model ( Case Manager and Social Worker teams are assigned to patients by physician practice) to… more
- LifePoint Health (Johnstown, PA)
- …Development and Growth Opportunities . And much more Position Summary: Provide Case Management leadership and management for hospitals within a market of Lifepoint ... and planning.Formulate and implement operational strategies and initiatives in the case management program.Ensure staff competencies in all areas of care management… more
- Highmark Health (Pittsburgh, PA)
- …**Job Description :** Date Posted: 20250509 Location: Allegheny General Hospital Department: Case Management, Inpatient Status: Full Time Shift: 80 hours every two ... Daylight M-F, 40 hours per week, rotating weekends and holidays Union: Yes ** CASE MANAGEMENT:** The Case Management Department at Allegheny General Hospital… more
- St. Luke's University Health Network (Bethlehem, PA)
- …to facilitate the achievement of desired patient, quality, and financial outcomes. In general, case managers are assigned to a specific campus. However, all case ... applicable state/federal regulatory notices as applicable ie.) Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON), Bundle… more
- WellSpan Health (Ephrata, PA)
- …families are involved. + Prepares and maintains required documentation on each case . **Common Expectations:** + Demonstrates knowledge of the principles of growth ... health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and… more
- St. Luke's University Health Network (Bethlehem, PA)
- …stay reviews, retro authorizations and other coverage related efforts. The Case Manager actively explores and utilizes available internal and external resources ... and interventions according to hospital policy and other regulatory guidelines (ie Medicare , CARF, JCAHO, etc.). Documentation is completed in a progressional and… more
- Cardinal Health (Harrisburg, PA)
- …about long and short-range changes in the reimbursement environment including Medicare , Medicaid, Managed Care, and Commercial medical and pharmacy plans while ... experience preferred + High School diploma or equivalent preferred + Knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for… more
- BAYADA Home Health Care (Dushore, PA)
- …or education/training experience strongly preferred. + Strong knowledge of Medicare /Medicaid regulations, OASIS documentation, and home health standards. + CPR ... Instructor certification a plus (or willingness to obtain). + Proficiency with electronic medical record systems. + Excellent communication, time management, and coaching skills. **Schedule & Travel:** + Full-time, Monday through Friday (occasional flexibility… more
- Prime Therapeutics (Harrisburg, PA)
- …in Excel, Word, and system operations (eg workflow processes and case management) + Government programs ( Medicare ) knowledge **Preferred Qualifications** ... all lines of business to support the Centers for Medicare & Medicaid Services (CMS) Star and HEDIS quality...meets the specialized needs of the targeted population; for Medicare , is Centers for Medicare & Medicaid… more