- WellSpan Health (Gettysburg, PA)
- …Degree Required **Work Experience:** + 1 year Relevant experience. Required **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered ... of care, the patient's diagnosis, corporate policy and procedures and the Nurse Practice Act. Carries primary care management functions for assigned patients.… more
- Highmark Health (Harrisburg, PA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care ... services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/ case management, and… more
- Highmark Health (Pittsburgh, PA)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Registered nurse who is proficient in the coordination of care and manages ... BSN **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + ACM Certification (Accredited Case Manager ) - American Case Management Association -… more
- Highmark Health (Jefferson Hills, PA)
- …BSN **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + ACM Certification (Accredited Case Manager ) - American Case Management Association - ... + Case Management - American Board of Occupational Health Nurses (ABOHN) andCertified Case Manager (CCM) + Commission for Case Manager Certification… more
- Penn Medicine (Philadelphia, PA)
- …(Outlook, Canopy, CERME, ECIN, shared drive, Internet) **Credentials:** + Registered Nurse - PA (Required) + PA RN Licensure required. Education or ... quality data collection and risk management referral. **Responsibilities:** + Utilization management activities: monitor appropriate use of internal resources,… more
- Amergis (Pittsburgh, PA)
- The RN Case Manager is...of services + Follows State/County mandated guidelines for the nurse case management programs + Participates in ... continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical regime. Essential… more
- Highmark Health (Pittsburgh, PA)
- …PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC). + Nationally recognized Case Management Certification ... **Job Description :** Date Posted: 20250509 Location: Allegheny General Hospital Department: Case Management, Inpatient Status: Full Time Shift: 80 hours every two… more
- Trinity Health (Philadelphia, PA)
- …+ Active PA RN License required. + Three (3) years of utilization management or case management experience, including emphasis on discharge planning. + ... member of Trinity Health Mid-Atlantic, is seeking an experienced RN Care Manager to join our team... Case Management certification from an accredited organization preferred **We… more
- Deloitte (Philadelphia, PA)
- …as clinical registered nurse , physician, physician assistant, case manager , clinical documentation specialist, utilization review, informatics ... Bachelor's degree in nursing, medical degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical… more
- UPMC (Pittsburgh, PA)
- Are you a registered nurse with a background in utilization management? UPMC Health Plan is looking for you! We are hiring a full-time Utilization ... Management Care Manager to support the Utilization Management Clinical Operations Department. This position will predominantly... management certification or approved clinical certification preferred + Registered Nurse ( RN ) + Act… more