• UM Case Manager

    Healthfirst (PA)
    …case management, identifying alternative care options, and discharge planning + Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of ... **This position is 100% Remote **Duties/Responsibilities:** + Provides case management services for assigned member caseloads which includes: + Pre-certification… more
    Healthfirst (05/08/25)
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  • Transplant Care Nurse RN - Stem…

    Highmark Health (Harrisburg, PA)
    …Inc. **Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. ... industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans… more
    Highmark Health (04/25/25)
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  • Clinical Care Manager or Senior/Mobile…

    UPMC (Pittsburgh, PA)
    …(or must be obtained within 2 years of hire to remain in role) + Registered Nurse ( RN ) **Licensure, Certifications, and Clearances:** + LSW, CSW, LCSW ... Master's degree in social work/human service field OR licensed RN (BSN preferred) OR Paramedic/EMT with 8-10 year of... utilization management, home care, discharge planning, and/or case management required + For Clinical Care Manager… more
    UPMC (05/06/25)
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  • Mobile Professional Care Manager…

    UPMC (Pittsburgh, PA)
    …Licensed Professional Counselor (LPC) OR Licensed Social Worker (LSW) OR Paramedic OR Psychologist OR Registered Nurse ( RN ) + Driver's License + Act 33 with ... LSW, CSW or LPC. + Three years of experience in behavioral, clinical, utilization management, home care, discharge planning, and/or case management required. +… more
    UPMC (04/11/25)
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  • Telephonic Care Manager

    UPMC (Pittsburgh, PA)
    …Clearances:** + Case management certification or approved clinical certification preferred + Registered Nurse ( RN ) + Act 34 *Current licensure either in ... by the interdisciplinary team summarizing clinical and social history, healthcare resource utilization , case management interventions. + Update the plan of care… more
    UPMC (05/08/25)
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  • Health Care Manager - Special Needs Plan…

    UPMC (Pittsburgh, PA)
    …from a designated UPMC office location daily **Licensure, Certifications, and Clearances:** + Registered Nurse ( RN ) or Social Services Licensure (LSW, LCSW, ... UPMC Health Plan is hiring a full-time Health Manager to support the Special Needs Plan team....Utilizes supervision by identifying and reporting to supervisor clinical, utilization and outcomes issues. + Preserve confidentiality of the… more
    UPMC (04/25/25)
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  • PPS Manager - Inpatient Rehab

    Select Medical (Hummelstown, PA)
    …PPS related job functions. **Qualifications** **Minimum Qualifications** + Current state licensure as a Registered Nurse ( RN ), PT, OT or SLP required + ... Select Medical & Penn State Health Hummelstown, PA **PPS Manager (MDS RN )** **This position qualifies for...Experience in ICD-10 coding preferred + Experience as a Case Manager in rehabilitation preferred **Additional Data**… more
    Select Medical (04/15/25)
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  • Manager - Home Health Clinical Intake…

    WellSpan Health (York, PA)
    Manager - Home Health Clinical Intake - Days...(eg, Home Health, Nursing, etc.) Required Licenses: + Licensed Registered Nurse Upon Hire Required or + ... Ensures positive working relationships with referral sources. Meets with Case Management & Preferred Providers as needed. Oversees Patient... Registered Nurse Multi State License Upon Hire Required or +… more
    WellSpan Health (04/05/25)
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  • Trinsic Nurse Care Manager Cofr-11

    Intermountain Health (Harrisburg, PA)
    …/Professional Nursing program. + Required Licensure/Certification: State licensure as a Registered Nurse ( RN ). Preferred Qualifications + Bachelor's ... outcomes. Provides focused support to various areas such as utilization management, emergency department, acute, ambulatory and specialty care....degree in Nursing. + Certified Case Manager (CCM). Relevant certification as determined… more
    Intermountain Health (05/02/25)
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  • Senior Discharge Plan Manager

    UPMC (Pittsburgh, PA)
    …. Are you an RN or social worker interested in care management, case management, or care coordination? UPMC is proud to announce the new Clinical Care ... and pay range listed are for Senior Discharge Plan Manager title. **Purpose:** The Senior Discharge Plan Manager...a focus on an optimal discharge plan with timely utilization of hospital resources. This optimal discharge plan reviews… more
    UPMC (05/09/25)
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