• R&E Nurse - Med Care Services- Advanced

    Health Advocates Network (Harrisburg, PA)
    …as a Registered Nurse issued by the Pennsylvania State Board of Nursing ; or Possession of a non-renewable temporary practice permit issued by the Pennsylvania ... setting, behavioral health setting, drug and alcohol setting, managed care, quality management / utilization review or other related clinical experience; or An… more
    Health Advocates Network (08/27/25)
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  • Telephonic Care Manager (RN) - Pediatric

    UPMC (Pittsburgh, PA)
    …concerns. + Minimum of 2 years of experience in a clinical setting and case management nursing required. + Pediatric nursing experience highly preferred. + ... Are you an experienced Pediatric nurse with care management experience? We...interdisciplinary team summarizing clinical and social history, healthcare resource utilization , case management interventions. Update the plan… more
    UPMC (10/14/25)
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  • Professional Care Manager

    UPMC (Pittsburgh, PA)
    …(CM) coordinates the clinical and financial plan for patients. Performs overall utilization management , resource management , discharge planning and ... care referrals and authorizations. Works with multi-disciplinary team in resource management , discharge planning and care facilitation. This position may require… more
    UPMC (09/17/25)
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  • Mobile Professional Care Manager - Allegheny…

    UPMC (Pittsburgh, PA)
    …or LSW, CSW or LPC. + Three years of experience in behavioral, clinical, utilization management , home care, discharge planning, and/or case management ... full-time Mobile Professional Care Manager to support the Care Management Department in Allegheny County! The Mobile Professional Care...Social Worker (LSW) OR Paramedic OR Psychologist OR Registered Nurse (RN) + Driver's License + Act 33 with… more
    UPMC (10/10/25)
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  • Mobile Professional Care Manager (Allegheny…

    UPMC (Pittsburgh, PA)
    …an LSW, LPC, or CSW + Three years of experience in behavioral, clinical, utilization management , home care, discharge planning, and/or case management ... Care Manager position to support the Population Health Case Management department. This is a Monday through Friday daylight...Social Worker (LSW) OR Paramedic OR Psychologist OR Registered Nurse (RN) *Current licensure either in the state where… more
    UPMC (08/29/25)
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  • Clinical Care Manager or Senior/Mobile…

    UPMC (Pittsburgh, PA)
    …with 6-8 year of experience. + 3 years of experience in behavioral, clinical, utilization management , home care, discharge planning, and/or case management ... years of experience in a clinical setting and case management nursing required. + Minimum 1 year...years of hire to remain in role) + Registered Nurse (RN) Licensure, Certifications, and Clearances: + LSW, CSW,… more
    UPMC (09/25/25)
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  • Mobile Professional Care Manager - Blair & Cambria…

    UPMC (Pittsburgh, PA)
    …Psychologist, LMFT or LPC + Three years of experience in behavioral, clinical, utilization management , home care, discharge planning, and/or case management ... and services across the continuum of care with case management , physicians, pharmacy, behavioral health, and other providers or...Social Worker (LSW) OR Paramedic OR Psychologist OR Registered Nurse (RN) + Act 33 with renewal + Act… more
    UPMC (08/13/25)
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  • Mobile Professional Care Manager - Clearfield…

    UPMC (Dubois, PA)
    …RN, LCSW, LSW, or LPC. + Three years of experience in behavioral, clinical, utilization management , home care, discharge planning, and/or case management ... Coordinates care and services across the continuum of care with case management , physicians, pharmacy, behavioral health, and other providers or health plan… more
    UPMC (08/08/25)
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  • Manager, Denial, Appeal, & Audit

    Guthrie (Sayre, PA)
    …adherence to payer-specific appeal timelines and protocols + Collaborate with clinical, utilization management , billing, HIM, and coding teams to resolve medical ... The Denial, Appeal, and Audit Manager is responsible for the oversight and management of all payer denials, appeals, and audit processes within the health system.… more
    Guthrie (10/03/25)
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  • Case Manager

    Select Medical (Hummelstown, PA)
    …allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and ... of the discharge planning process. + The primary job functions in Case Management include: + Clinical Interventions/Discharge Planning + Care Planning Management more
    Select Medical (10/11/25)
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