- CVS Health (Harrisburg, PA)
- …- 3+ years of acute experience as a Registered Nurse - 1+ years of Utilization Management experience - Must have experience using MS Office suites - Must be ... year - Occasional travel less than 5% to complete audits/meetings - Utilization Management is a 24/7 operation and work schedules will include weekends,… more
- UPMC (Erie, PA)
- …aligned with organizational goals. + Demonstrates fiscal responsibility in budget management and resource utilization . + Establishes high performance standards ... department orientation, and fostering a culture of continuous performance management . This includes completing and delivering employee evaluations, managing daily… more
- UPMC (Pittsburgh, PA)
- …evidence on medical interventions, as well as coverage policies and utilization management standards of national insurers, accountable care organizations, ... report results. + BSN required. Advanced degree is preferred. + Prior experience with utilization management and/or case management is strongly preferred. +… more
- UPMC (Williamsport, PA)
- …for achieving high-quality patient care through effective leadership and optimal utilization of human and fiscal resources. Additionally, this position oversees the ... goals aligned with UPMC's short- and long-term objectives. + Oversee capacity management and develop tactics to influence budgeted outcomes, including average length… more
- WellSpan Health (York, PA)
- …with team members to identify root cause and countermeasures.* Holds In Episode Management meetings on a regularly scheduled basis with individual staff to ensure ... safe quality care, progress towards goals, and proper utilization of services. * Provides after-hours and on-call staff support as well as visits and consultation on… more
- UPMC (Washington, PA)
- …work on all the inpatient units. + Five years of experience in clinical, utilization management , home care, discharge planning, and/or case management ... we want to hear from you!_ Responsibilities: * Provide case management according to program descriptions including member/patient education, follow up on… more
- ZOLL Medical Corporation (Reading, PA)
- …patients suffering from serious cardiopulmonary and respiratory conditions.ZOLL Cardiac Management Solutions offers a unique portfolio of novel technologies designed ... patients at risk of sudden cardiac death. + HFMS (https://cardiacdiagnostics.zoll.com/products/heart-failure-arrhythmia- management -system/) (Heart Failure Management system) is a… more
- St. Luke's University Health Network (Allentown, PA)
- …for admission and/or referral to appropriate level of care. + May assist in the utilization management of psychiatric cases in the absence of the utilization ... and the Manager regarding variances, aspects of patient care management . + Facilitates insurance authorization, pre-certification, and concurrent reviews for… more
- Highmark Health (Pittsburgh, PA)
- …the enhanced Nurse Licensure Compact (eNLC). + Nationally recognized Case Management Certification within 5 years of start date. + Critical thinking and problem ... Description :** Date Posted: 20250509 Location: Allegheny General Hospital Department: Case Management , Inpatient Status: Full Time Shift: 80 hours every two weeks… more
- UPMC (Harrisburg, PA)
- …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... Registered Nurse Home Health Harrisburg Are you a ...patients' needs. + RN will coordinate case management activities across a multi-disciplinary health care team to… more