- Sedgwick (Harrisburg, PA)
- …for evaluating the following: + Conducting reviews on cases where the nurse is seeking treatment plan clarification, claim denial, disability certification or ... duration management for return to work guidance. + Generating phone...required to include one (1) to three (3) years utilization review experience and three (3) years clinical quality… more
- Trinity Health (Philadelphia, PA)
- …The Registered Nurse (RN) is responsible for providing oversight and management to the provision of service delivery to participants. Provide skilled nursing ... **Employment Type:** Part time **Shift:** **Description:** **Registered Nurse ** **Location: LIFE Broad Street, Philadelphia PA** **Status:** On-Call **Shift:**… more
- UPMC (Coudersport, PA)
- …and reactions regarding patient to the appropriate person (ie, physicians, director, nurse manager, charge nurse and/or nursing supervisor) and records those ... thoracentesis, lumbar tap, etc. + Participates in the economical utilization of supplies and ensures that equipment is maintained...and response to pain. + Educates patients in pain management and its impact on patient outcome. + A… more
- UPMC (Coudersport, PA)
- …and reactions regarding patient to the appropriate person (ie, physicians, director, nurse manager, charge nurse and/or nursing supervisor) and records those ... thoracentesis, lumbar tap, etc. + Participates in the economical utilization of supplies and ensures that equipment is maintained...level and response to pain. Educates patients in pain management and its impact on patient outcome. + A… more
- UPMC (Mckeesport, PA)
- …hireCCMC required within 90 days of hire. + Basic Life Support (BLS) + Comprehensive Crisis Management (CCMC) + Registered Nurse (RN) + Act 33 with renewal + Act ... department orientation, and fostering a culture of continuous performance management . This includes completing and delivering employee evaluations, managing daily… 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
- Prime Healthcare (Bristol, PA)
- …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and ... institution in a Health and Human Services field is highly preferred. 2. Utilization Review/Case Management experience is highly preferred. 3. 1+ year of… 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
- WellSpan Health (York, PA)
- …8 am to 4:30 pm Hybrid Remote Work **Program Description:** WellSpan's Care Management team helps patients reach their best possible health in the right setting ... in a cost-effective manner. The Care Management team reviews benefits and resources, plus develops and...improve care, patients experience and reduce unnecessary cost and utilization : right care, right place, right time. + Assists… more
- UPMC (Altoona, PA)
- **UPMC Altoona is seeking a Registered Nurse with leadership experience for an exciting opportunity as a Unit Director for our T11 Trauma unit!** In this challenging ... amazing team of Nurses, Nursing Assistants, Physical Therapists, Physicians, and Case Management , who collaborate to provide exceptional patient care to our diverse… more