• Case Management Manager - UPMC

    UPMC (Washington, PA)
    …**Licensure, Certifications, and Clearances:** + Current licensure as a Registered Nurse in practicing state required. + UPMC approved Care Management certification ... care/treatment, The Joint Commission Standards, Federal/State regulations relative to utilization /case management, discharge planning, Medicare, Medicaid, and other third… more
    UPMC (07/11/25)
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  • Rehabilitation Liaison- Good Samaritan Hospital-…

    WellSpan Health (York, PA)
    …members, referral sources and external payers regarding the effective and efficient utilization of program service and available resources as well as the benefit ... or Respiratory Therapy experience. Required **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered Nurse... Nurse Upon Hire Required or + Registered Nurse Multi State License Upon Hire Required or +… more
    WellSpan Health (07/08/25)
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  • DRG Specialist

    UPMC (Pittsburgh, PA)
    …documentation within the medical record to ensure that all patient resource utilization , principal diagnosis, secondary diagnoses, and PCS procedures have been coded ... Coding Specialist (CCS) OR Certified Professional Coder (CPC) OR Certified Registered Nurse Practitioner OR Doctor of Medicine (MD) OR Registered Health Information… more
    UPMC (06/11/25)
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  • Experienced RN - Per Diem - Operating Room

    Geisinger (Shamokin, PA)
    …and handling of equipment. + Participates in unit-based decision-making regarding the utilization of evidence- based practice. + Actively participates as a team ... Geisinger Shamokin Area Community Hospital is looking for an experienced OR nurse to join their team! Position Details/Requirements: Per Diem/Flex hours (minimum of… more
    Geisinger (06/08/25)
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  • Case Manager/ Discharge Planner - Per Diem

    Select Medical (Hummelstown, PA)
    …timeframe; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safeand appropriate discharge ... Licensure in a clinical discipline per state guidelines required. (Registered Nurse or Social Work (SW) preferred) **Previous Experience** + Previous experience… more
    Select Medical (08/23/25)
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  • Senior Medical Science Liaison, Immunology…

    J&J Family of Companies (Pittsburgh, PA)
    …**Qualifications:** + PharmD, PhD, MD, or other advanced medical degree NP ( Nurse Practitioner), PA (Physician Assistant), with +3 years relevant TA clinical ... and/or Immunology. + Must be familiar with Microsoft Word, Excel, PowerPoint, and utilization of computers and remote technologies. + Reside in or near Pittsburgh,… more
    J&J Family of Companies (08/20/25)
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  • Mobile Professional Care Manager - Blair County

    UPMC (Pittsburgh, PA)
    …human services field. + Three years of experience in behavioral, clinical, utilization management, home care, discharge planning, and/or case management required. + ... Counselor (LPC) OR Licensed Social Worker (LSW) OR Paramedic OR Psychologist OR Registered Nurse (RN). Preference will be given to those with an RN, CSW, LCSW, LMFT,… more
    UPMC (08/20/25)
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  • Health Care Manager (Pediatric)

    UPMC (Pittsburgh, PA)
    …implemented. + Utilizes supervision by identifying and reporting to supervisor clinical, utilization and outcomes issues. + Preserve confidentiality of the member. + ... of community resources required. **Licensure, Certifications, and Clearances:** + Registered Nurse (RN) OR Social Services Licensure (LSW, LCSW, LPC) + Licensure… more
    UPMC (08/20/25)
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  • Denials Management Specialist, Remote within Local…

    St. Luke's University Health Network (Allentown, PA)
    …visual monotony. EDUCATION: Graduate of an accredited professional nursing program. Registered nurse with current license to practice in the state of Pennsylvania or ... Prefer minimum of 2-5 years' experience in case management and/or utilization management required. Prefer financial experience related to appeal processes with… more
    St. Luke's University Health Network (08/19/25)
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  • Unit Director ICU

    UPMC (Pittsburgh, PA)
    …+ Supports shared governance through a unit-based professional practice council and utilization of staff feedback to make changes to improve care, nursing practice, ... three (3) years of enrollment. **Licensure, Certifications, and Clearances:** + Registered Nurse (RN) + Current licensure either in the state where the facility… more
    UPMC (08/16/25)
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