- UPMC (Pittsburgh, PA)
- …with a Pennsylvania RN license. The Utilization Management (UM) Care Manager is responsible for utilization review of health plan services and ... Health Plan is hiring a flex full-time UM Care Manager to support our UM Clinical Operations team. This...Case management certification or approved clinical certification preferred + Registered Nurse ( RN ) *Current licensure… more
- Penn Medicine (Philadelphia, PA)
- … Nurse - PA (Required) + 5yrs prior experience as a Nurse Case Manager with knowledge of utilization review and 3rd Party Payors (Required) + ... each day. Are you living your life's work? Job Title: RN Pre Certification Case Manager Department: Business...years Prior experience as a nurse case manager with knowledge of utilization review… more
- Geisinger (Wilkes-Barre, PA)
- …Experience Minimum of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; Basic Life ... Top 8 Most Innovative Healthcare Systems in Becker's Hospital Review , we're working to create a national model for...rewarding, lasting career with impact. Join us as an RN Case Manager in Care Coordination to… more
- LifePoint Health (Johnstown, PA)
- * Registered Nurse ( RN ), Case Manager ...team of RN Case Managers, Social Workers, Utilization Review staff, and Discharge Planners assure ... you're not just valued as an employee, but as a person. As a* registered nurse ( RN )*joining our team, you're embracing a vital mission dedicated to/making… more
- Fresenius Medical Center (Philadelphia, PA)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- Commonwealth of Pennsylvania (PA)
- Registered Nurse Supervisor (2nd Shift) -...will include planning and organizing work under direction of Nurse Manager , as well as serving as ... Selinsgrove Center Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5002155) Apply Registered Nurse Supervisor (2nd Shift) - Selinsgrove… more
- CVS Health (Harrisburg, PA)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Guthrie (Troy, PA)
- …or, a Bachelor of Arts (BA) degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to pursue a BSN or ... of hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who...in an acute care setting with strong care management, utilization review , and payer knowledge. A Case… more
- CenterWell (Lancaster, PA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- ChenMed (Philadelphia, PA)
- …RN with bachelor's degree in a related clinical field preferred + A valid, active Registered Nurse ( RN ) license in State of employment required + Compact ... working remote for the remaining hours. The Acute Care Manager , Complex Care ( RN ) is responsible for...patients' progress and adjust and plan accordingly + Understanding utilization review and how to leverage with… more