• Mobile Professional Care Manager - Beaver…

    UPMC (Pittsburgh, PA)
    …6-8 year of experience. + 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 Beaver & Lawrence Counties! The Mobile...Social Worker (LSW) OR Paramedic OR Psychologist OR Registered Nurse (RN) *Current licensure either in the state where… more
    UPMC (11/13/25)
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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 (11/12/25)
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  • LCSW - Social Worker Case Manager

    ERP International (Luke AFB, AZ)
    …and 5:00pm, including a one hour lunch **Core Duties:** * Participate in Utilization Management /Case Management meetings to review and identify opportunities ... strategies that use the strength and disciplines of both nursing and social work to accomplish case management... nursing and social work to accomplish case management . * Provide assistance in the development and implementation… more
    ERP International (10/24/25)
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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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  • MLT/MLS Section Head

    Access Dubuque (Dubuque, IA)
    …Administrative Assistant O'Connor, Brooks & Co, PC Seasonal Screen Printer 1800TShirts Utilization Management CNA Cottingham & Butler/ SISCO Floor Supervisor ... assessment. The section head oversees staff and workflow in the absence of management personnel. Assists with the Quality Management Program, patient test … more
    Access Dubuque (11/21/25)
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  • Quality Outcomes Specialist - Perioperative

    Houston Methodist (Houston, TX)
    …in a hospital setting + Two years of experience in Hospital Quality Improvement, Case Management or Utilization Management role preferred + Two years of ... Conducts record review for performance improvement, peer review, patient safety, risk management and other projects. + Facilitates and leads process and performance… more
    Houston Methodist (11/02/25)
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  • Denial Analyst - Revenue Integrity - Full Time…

    Montrose Memorial Hospital (Montrose, CO)
    …preferred. + Minimum work experience: Three (3) years' experience working within case management , utilization management or denial management . Experience ... Analyst is a key contributor within the interdisciplinary Denial Management Program and is responsible for completing, tracking, and...write-offs. All About You : + ASN Degree in Nursing or other relevant healthcare field. Bachelor's in … more
    Montrose Memorial Hospital (10/07/25)
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  • RN Case Coordinator

    Hartford HealthCare (Hartford, CT)
    …continuum; identify risk factors; facilitate involvement of support services; perform utilization management functions; develop and implement transition planning ... years acute-care, and diversified clinical nursing experience, including medical/surgical nursing is required; case management , home care, and/or managed… more
    Hartford HealthCare (11/26/25)
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  • Case Manager PRN

    Select Medical (Harrisburg, 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 (11/12/25)
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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 (11/07/25)
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