• Intensive Care Manager RN - Population Health…

    WellSpan Health (York, PA)
    …care plans to maximize healthcare outcomes and facilitate wellness with periodic review and update according to department protocols. + Perform medication review ... management to improve care, patients experience and reduce unnecessary cost and utilization : right care, right place, right time. + Assists patients in navigating… more
    WellSpan Health (08/19/25)
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  • Pediatrician / Family Practice

    KidsPeace Childrens Hospital (Schnecksville, PA)
    …and/or services based on the needs of the organization; + Participating in utilization review activities including but not limited to development of standards, ... history and physical examination, either written or dictated. This includes a review of the immunization status, allergies, past history, family history and… more
    KidsPeace Childrens Hospital (07/09/25)
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  • Physician

    YesCare Corp (Philadelphia, PA)
    …measures including sentinel event review . + Actively participant of the Utilization Review process and follow proper procedures. + Other duties as ... in-service education of staff as requested. Participates in monthly review of quality of care and chart reviews as...and chart reviews as requested. Sponsors physician assistants or nurse practitioners as required. + Notifies Site Medical Director… more
    YesCare Corp (06/05/25)
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  • Associate Clinical Manager LPN Neuroscience Shared…

    Penn Medicine (Philadelphia, PA)
    …accurate timecard review and approval, reviews and manages all overtime utilization . + Assists with the implementation of change management strategies within the ... Experience:** + HS Diploma/GED (Required) + Graduate of a state approved Practical Nurse Program (Required) + And 3+ years practical nursing experience (Required) +… more
    Penn Medicine (08/16/25)
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  • CDI Specialist

    UPMC (Pittsburgh, PA)
    …+ Knowledge of computer technology, quality assurance activities, DRG, Quality Insights/ Utilization review background is highly preferred. + Ability to ... Certifications, and Clearances:** + Certified Coding Specialist (CCS) OR Certified Registered Nurse Practitioner OR Doctor of Medicine (MD) OR Doctor of Podiatric… more
    UPMC (08/13/25)
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  • RN Care Coordinator PCMH (Patient Centered Medical…

    Guthrie (Sayre, PA)
    …and autonomy in nursing practice. Preferred experience with PCMH process, care management/ utilization review , and payer knowledge. Fast paced ambulatory care ... process outcome evaluation. Education, License & Cert: Licensed Registered Nurse . Bachelor's Degree in Nursing or related field required....must have a current license as a Professional Registered Nurse in their state of practice prior to position… more
    Guthrie (08/12/25)
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  • Supervisor, Clinical Care Coordination

    UPMC (Mckeesport, PA)
    …required. + Knowledge and Skills:Expertise in care management, discharge planning and utilization review processes. + Ability to build credible and effective ... alongside the Unit Director, RN Clinician and Addiction Medicine Nurse Liaison to ensure patients are enjoying robust daily...Other Healthcare Professional Licenses for Discharge Planning OR Registered Nurse (RN) + Act 33 with renewal + Act… more
    UPMC (08/09/25)
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  • Per Diem Diagnosis/Oasis Specialist

    St. Luke's University Health Network (Bethlehem, PA)
    …JOB DUTIES AND RESPONSIBILITIES: + Reviews documentation from Liaison/Intake nurse , referral source, Medical Director and admitting clinician. Utilizing standard ... Consistently meets established productivity targets for coding assignment and record review . + Communicates and collaborates with Quality Managers, Patient Care… more
    St. Luke's University Health Network (07/22/25)
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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 ... and need for inpatient level rehabilitation services. Assessment includes chart review , clinical physical assessment and interaction with the physician, nurses and… more
    WellSpan Health (07/08/25)
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  • Associate Clinical Manager Ambulatory RN

    Penn Medicine (Radnor, PA)
    …+ Manage pay practices including accurate timecard review and approval, review and manage all overtime utilization + Assists with the implementation ... to enable high performance of team and individuals Credentials: + Registered Nurse - PA (Required) + BLS/ACLS/PALS per specialty (Required) Education or Equivalent… more
    Penn Medicine (08/14/25)
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