- CenterWell (Harrisburg, PA)
- …Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid… more
- Penn Medicine (Philadelphia, PA)
- …+ Registered Nurse - PA (Required) + 5yrs prior experience as a Nurse Case Manager with knowledge of utilization review and 3rd Party Payors (Required) + ... Experience: * And 5+ years Prior experience as a nurse case manager with knowledge of utilization review and third-party payors. We believe that the best care… more
- Penn Medicine (Philadelphia, PA)
- …critical thinking skills and being a strong patient advocate. The case manager conducts utilization management activities, communication with insurers, team, and ... shifts but are fearful you will miss patient contact? If so, our nurse case manager role at Penn Medicine is the perfect transition career for you, and will bring… more
- WellSpan Health (Lebanon, PA)
- …4pm Weekend rotation **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of ... address patient discharge needs. Provides leadership in the integration of utilization and case management principles. **Duties and Responsibilities** + Reviews… more
- WellSpan Health (York, PA)
- …weekend requirement **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of ... address patient discharge needs. Provides leadership in the integration of utilization and case management principles. **Essential Functions:** + Reviews assigned… more
- Magellan Health Services (Somerset, PA)
- …Strong organization, time management and communication skills.* Knowledge of utilization management procedures, mental health and substance abuse community resources ... of DSM V or most current diagnostic edition.* Ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care.… more
- Magellan Health Services (Bethlehem, PA)
- …DSM V or most current diagnostic edition and ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care ... and other clinical team members through content knowledge, technical and utilization management expertise. Researches open questions and unresolved issues for Care… more
- Redeemer Health Home Care & Hospice (Meadowbrook, PA)
- …SUMMARY OF JOB UP TO $6000 SIGN ON BONUS The role of the ER Care Manager is to increase patient through put to the most appropriate level of care while facilitating ... interdisciplinary care across the continuum. The ER Care Manager will assist in identifying patients appropriate for Admission, Observation or other patient care… more
- CDR Maguire (Allentown, PA)
- …As overseen by the PA Director of Construction Services and Construction Services Manager - PA East, provide Construction Management Support for PennDOT and PA ... as overseen by the PA Director of Construction Services and Construction Services Manager - PA East: + Promote excellent internal and external client service… more
- Highmark Health (Monroeville, PA)
- …outcomes, engages patients/caregivers in their healthcare, and supports effective resource utilization . Serves as key team members in the management of readmissions, ... length of stay, ED utilization , and patient/family satisfaction. **ESSENTIAL RESPONSIBILITIES:** + Contributes to or completes comprehensive assessment of patients… more