- UPMC (Pittsburgh, PA)
- …OR Cardiopulmonary Resuscitation (CPR) + Certified Case Manager (CCM) + Driver's License + Registered Nurse ( RN ) + Act 33 with renewal + Act 34 with ... UPMC Health Plan is hiring a full-time Clinical Care Manager to support our partnership with various physician practices....experience required. + 1 year of experience in clinical, utilization management , home care, discharge planning, and/or… more
- Highmark Health (Monroeville, PA)
- …also building relationships across the organization in a community setting. **GENERAL OVERVIEW:** Registered nurse who is proficient in the coordination of care ... and third party payers. + Maintains a working knowledge of care management , care coordination changes, utilization review changes, authorization changes,… more
- CenterWell (Harrisburg, PA)
- … RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- CenterWell (Harrisburg, PA)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
- WellSpan Health (York, PA)
- …Required **Work Experience:** + 2 years Recent acute care experience. Required + Utilization management , case management , or clinical nursing specialty. ... **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine...Preferred **Licenses:** + Licensed Registered Nurse Upon… more
- Guthrie (Sayre, PA)
- …role related to professional specialty. Education, License & Cert: Licensed as a Registered Nurse in the State of Pennsylvania/New York. Certification within ... Core Values in all activities. Mentors under the Clinical Manager / Director and pursues management and...care. Manages daily staffing issues in conjunction with Charge Nurse / Nurse Manager , analyzing… more
- Penn Medicine (Philadelphia, PA)
- …assignment (Outlook, Canopy, CERME, ECIN, shared drive, Internet) Credentials: + Registered Nurse - PA (Required) + PA RN Licensure required. Education or ... hospice, community resources, transportation, and quality data collection and risk management referral. Responsibilities: + Utilization management … more
- Genesis Healthcare (York, PA)
- …while making a meaningful impact in the communities we serve. Responsibilities The Manager , Case Management is responsible for the clinical, administrative, and ... responding to the needs of its payor customers. The Manager will also perform the functions of the Case...of clinical nursing experience is required. Prior experience in utilization review, case management or discharge planning… more
- Highmark Health (Monroeville, PA)
- …effective resource utilization . Serves as key team members in the management of readmissions, length of stay, ED utilization , and patient/family ... or CERTIFICATIONS** **Required** + None **Preferred** + ACM Certification (Accredited Case Manager ) - American Case Management Association - American Case … more
- UPMC (Coudersport, PA)
- …Educates patients in pain management and its impact on patient outcome.t. A Registered Nurse who has taken a basic arrhythmia class and completed the ... regarding patient to the appropriate person (ie, physicians, director, nurse manager , charge nurse and/or...Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Registered Nurse ( RN ) + Act… more