- Penn Medicine (Philadelphia, PA)
- …assignment (Outlook, Canopy, CERME, ECIN, shared drive, Internet) Credentials: + Registered Nurse - PA (Required) + PA RN Licensure required. Education or ... Canopy concurrentlyAccounts for all patient days accurately in CanopyEnters review indicating "pending" status of case if...Experience: + Bachelor of Arts or Science (Required) + Utilization Review experience (Required) + Bachelor's Degree… more
- ChenMed (Philadelphia, PA)
- …RN with bachelor's degree in a related clinical field preferred + A valid, active Registered Nurse ( RN ) license in State of employment required + Compact ... the remaining hours. The Acute Care Manager, Complex Care ( RN ) is responsible for achieving positive patient outcomes, managing...required + A minimum of one (1) year of utilization review and/or case management,… more
- LifePoint Health (Johnstown, PA)
- * Registered Nurse ( RN ), Case Manager...of hospitalized patients. Our team of RN Case Managers, Social Workers, Utilization Review ... prohibiting discrimination and harassment in employment. **Job:** **Nursing* **Organization:** ** **Title:** * Registered Nurse ( RN )- Case Management… more
- Guthrie (Sayre, PA)
- …of experience in an acute care setting with strong care management, utilization review , and payer knowledge. A Case Management certification or obtaining a ... make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout...degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant… more
- Geisinger (Danville, PA)
- …rotation . At least two (2) years of RN work experience is required. Registered Nurse - Case Manager - Care Coordination + Integrates evidence-based ... Right now, is the best time to join the RN Hospital Case Manager team at Geisinger....Basic Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania… more
- Healthfirst (PA)
- …with experience in appeals & grievances, claims processing, utilization review or utilization management/ case management. + Demonstrated understanding ... Specialist against expectations + Prepare cases for Medical Director Review ensuring that all pertinent information (ie case...of Utilization Review Guidelines (NYS ART 44 and 49 PHL), InterQual,… more
- St. Luke's University Health Network (Allentown, PA)
- …near vision, visual monotony. EDUCATION: Graduate of an accredited professional nursing program. Registered nurse with current license to practice in the state ... care hospital setting required. Prefer minimum of 2-5 years' experience in case management and/or utilization management required. Prefer financial experience… more
- Intermountain Health (Harrisburg, PA)
- …specialty care settings or previous appeals experience. + Demonstrated experience in utilization review and/or case management, hospital insurance billing, ... in the court of law. **Essential Functions** + Uses nationally recognized evidence-based utilization review criteria (such as Milliman Care Guidelines (MCG) or… more
- Prime Healthcare (Bristol, PA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/222597/ case -manager- rn ... an accredited school of nursing and a current state Registered Nurse license + Grandfathered prior to...Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. + Five years… more
- Redeemer Health Home Care & Hospice (Meadowbrook, PA)
- …REQUIREMENTS: Must have current RN licensure (BSN preferred)). Adheres to the Case Management Society of America (CMSA) Standards, Nurse Practice Act as ... to work and adjust to different environments. Knowledge of Interqual and utilization review standards. Experience in clinical documentation within electronic… more