- UPMC (Altoona, PA)
- …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... CAMBRIA, SOMERSET, HUNTINGDON, MIFFLIN, AND CENTRE. Are you a nurse looking for a rewarding career where you can...and compassionate registered nurses to join our home health nursing team! You'll work in a home setting with… more
- UPMC (Erie, PA)
- …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... RN for the Erie County area! Are you a nurse looking for a rewarding career where you can...and compassionate registered nurses to join our home health nursing team! You'll work in a home setting with… more
- UPMC (Pittsburgh, PA)
- …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... **UPMC Home Health is hiring a Registered Nurse for the Uniontown Area** Are you a...skilled, compassionate registered nurses to join our home health nursing team! You'll work in a home setting with… more
- UPMC (Erie, PA)
- …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... for the Southern Erie County area! Are you a nurse looking for a rewarding career where you can...and compassionate registered nurses to join our home health nursing team! You'll work in a home setting with… more
- Highmark Health (Harrisburg, PA)
- …Risk Compliance Analyst is responsible for monitoring and analyzing medical and utilization management activities to ensure compliance with internal policies, ... and guidance to internal departments. The Analyst conducts audits of Medical Directors, Utilization Management (UM) and Case Management (CM) processes and… more
- Penn Medicine (Philadelphia, PA)
- …hospice, community resources, transportation, and quality data collection and risk management referral. Responsibilities: + Utilization management ... community resourcesParticipates and drives accountability in daily interdisciplinary meetings Utilization Management :Adheres to guidelines to satisfy 3rd party… 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 effective communication with patients, families, community agencies, physicians, nursing staff, department managers, ancillary departments, and the Manager… more
- Trinity Health (Philadelphia, PA)
- …overall performance of the team including quality patient care, financial performance, utilization management , and compliance with state and federal regulations. ... care nursing experience required, and one (1) year of management experience preferred. Qualified applicants are encouraged to apply online at… more
- 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
- Humana (Harrisburg, PA)
- …during Medicare and Medicaid LOB - Medicare Clinical Criteria Review (MCCR), Utilization Management Committee (UMC), Medical Coverage Policy Adoption (MCPA) + ... **Desired Qualifications** + Master's degree in health-or business-related field + Utilization management experience (Commercial and/or Medicare) + Proven… more