• UM Care Manager ( RN…

    UPMC (Pittsburgh, PA)
    …Friday. Preference will be given to candidates located in Pennsylvania The Utilization Management ( UM ) Care Manager is responsible for utilization review of ... for you! We are hiring a full-time Utilization Management Care Manager to support the Utilization Management...Case management certification or approved clinical certification preferred + Registered Nurse ( RN ) *Current licensure… more
    UPMC (10/23/25)
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  • UM Case Manager

    Healthfirst (PA)
    …alternative care options, and discharge planning** + **Certified Case Manager ** + **Interqual and//or Milliman knowledge** + **Knowledge of Centers for Medicare ... + **Functions as a clinical resource for the multi-disciplinary care team in order to maximize HF member ...as necessary** + **Additional duties as assigned** **Minimum Qualifications:** ** RN , LPN, LMSW, LMHC,LMFT, LCSW, PT, OT, and//or ST… more
    Healthfirst (10/23/25)
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  • Professional Care Manager…

    UPMC (Pittsburgh, PA)
    UPMC Health Plan is seeking a full-time Professional Care Manager , Supervisor to join our Utilization Management ( UM ) Clinical Operations team. This position ... experience required + 4 years of care manager experience required + Prior UM experience...or 1 year health plan management experience required + Registered Nurse ( RN ) + Act… more
    UPMC (10/23/25)
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  • Telephonic Nurse Case Manager

    Humana (Harrisburg, PA)
    …**Required Qualifications** + Bachelor's degree in Nurse (BSN). + Valid and unrestricted Registered Nurse ( RN ) license in the (appropriate state) with no ... desired clinical outcomes and to enhance quality of medical care . The **Telephonic Nurse Case Manager...Management programs (DM/PN) as needed, in addition to MTF UM / CM staff, physicians and providers as necessary;… more
    Humana (10/23/25)
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  • Transplant Care Nurse - Remote

    Highmark Health (Harrisburg, PA)
    …established industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create ... in a clinical setting **Preferred** + 5 years in UM /CM/QA/Managed Care + 1 year in advanced...in addressing targeted populations **LICENSES or CERTIFICATIONS** **Required** + RN license in PA or WV or DE or… more
    Highmark Health (10/10/25)
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