- Penn State Health (Hershey, PA)
- …and family medical or genetic information._ \#LI-TB1 IND567 **Union:** Non Bargained **Position** Manager Utilization Management - Utilization ... **SUMMARY OF POSITION:** Position is responsible to thoroughly understand all Utilization Management regulatory requirements for both CMS and DOH,… more
- Healthfirst (PA)
- **Duties/Responsibilities:** + Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review, ... and reviews medical charts to obtain additional information required for appropriate utilization management and to solve complex clinical problems + Allocate,… more
- AmeriHealth Caritas (Philadelphia, PA)
- …pediatric patients in a clinical setting + Minimum of 3 years of Utilization Management experience, preferably within a managed care organization + Experience ... Clinical Care Reviewer refers the member to a Special Needs/Pediatric Shift Care Case Manager and works collaboratively with that Case Manager to ensure the… more
- Guthrie (Troy, PA)
- …approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of ... hospital inpatient admissions and short procedures by translating clinical information to Utilization Management requirements using pre ‐ determined criteria. b.… more
- Genesis Healthcare (York, PA)
- …while making a meaningful impact in the communities we serve. Responsibilities The Manager , Case Management is responsible for the clinical, administrative, and ... responding to the needs of its payor customers. The Manager will also perform the functions of the Case...of clinical nursing experience is required. Prior experience in utilization review, case management or discharge planning… 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) + ... not limited to admissions, patient financial services, clinical resource management and provider medical staff and designees.Assist in preparation...And 5+ years Prior experience as a nurse case manager with knowledge of utilization review and… more
- Motion Recruitment Partners (Harrisburg, PA)
- Sr. Mission Manager **Remote Only** Contract to Hire $70/hr - $100/hr **TG Federal is actively seeking a Sr. Mission Manager to join our remote team of ... Cybersecurity professionals.** **Summary:** The Sr. Mission Manager is a hybrid leadership role that combines the...operations team. + Track, manage, and report on labor utilization , forecasting, and burn rates to ensure alignment with… more
- Highmark Health (Erie, PA)
- …effective resource utilization . Serves as key team members in the management of readmissions, length of stay, ED utilization , and patient/family ... or CERTIFICATIONS** **Required** + None **Preferred** + ACM Certification (Accredited Case Manager ) - American Case Management Association - American Case … more
- St. Luke's University Health Network (Allentown, PA)
- …, including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director. + Facilitates communication among all ... Care Manager coordinates the overall progression of care, resource utilization , and discharge planning for designated patient populations across the continuum of… 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 ... Preferred- Professional Engineer in Pennsylvania for Civil Engineering (PE); Project Management Professional (PMP); Certified Construction Manager (CCM). +… more
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