- 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
- Highmark Health (Harrisburg, PA)
- …Proven ability to deliver engaging and informative product demonstrations and walkthroughs. + ** Utilization Management & Clinical Expertise:** + Utilization ... Management Knowledge: A strong understanding of utilization management principles, processes, and industry best practices. + Clinical Knowledge: Familiarity… 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
- Penn Medicine (Philadelphia, PA)
- …their critical thinking skills and being a strong patient advocate. The case manager conducts utilization management activities, communication with insurers, ... hospice, community resources, transportation, and quality data collection and risk management referral. + Responsibilities: Utilization management … more
- Select Medical (Mckeesport, PA)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... **Overview** **Critical Illness Recovery Hospital** **Case Manager (PRN)** _Requires a current licensure in a...the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates… more
- Select Medical (York, PA)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... **Overview** **Critical Illness Recovery Hospital** **Case Manager ** _Requires a current licensure in a clinical...the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates… more
- Performance Food Group (Wilkes Barre, PA)
- …Coordinates pick planning in conjunction with the Warehouse Manager . + Utilization of Company's warehouse management system and other technologies available ... candidate should possess:** + Strong knowledge of warehouse procedures, inventory management , and material handling equipment. + Experience with inventory … 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
- St. Luke's University Health Network (Allentown, PA)
- …patient's ability to pay for health care. The IT Vendor and Contracts Manager leads IT's Vendor/Contact Management Office (VCMO). Responsibilities include but ... and attainment, reporting and governance. At an operational level, the Manager directs contract consultations and negotiations, including contract reviews, analysis,… more
- UPMC (Washington, PA)
- The Manager oversees the day-to-day operations of the Case management department under the direction of the Director. The Manager is accountable for the ... care/treatment, The Joint Commission Standards, Federal/State regulations relative to utilization /case management , discharge planning, Medicare, Medicaid, and… 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
- 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
- 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
- UPMC (Pittsburgh, PA)
- …of health insurance experience required. + 1 year of experience in clinical, utilization management , home care, discharge planning, and/or case management ... by the interdisciplinary team summarizing clinical and social history, healthcare resource utilization , case management interventions. Update the plan of care… 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
- Penn Medicine (Lancaster, PA)
- … management platform/analytics. + Analyzes data to identify under/over utilization ; improve resource consumption; promotes potential reduction in cost and ... per week). Monday-Friday (8am-4:30pm). No weekends or holidays. The Ambulatory Case Manager will provide support to physicians, clinical staff and patients who fall… more
- UPMC (Hanover, PA)
- **$6,000 sign on bonus offered ** The Discharge Plan Manager functions as the coordinator and is accountable for all post-discharge needs and acts as financial ... and placing a focus on an optimal discharge plan with timely utilization of hospital resources. This optimal discharge plan reviews discipline recommendations and… more
- Guthrie (Sayre, PA)
- …staff, exhibiting the Core Values in all activities. Mentors under the Clinical Manager / Director and pursues management and leadership training within the ... / Director informed of clinical issues, triage problems, staffing issues, and risk management concerns. Acts on behalf of Clinical Manager / Director in his/her… more
- Highmark Health (Monroeville, PA)
- …and third party payers. + Maintains a working knowledge of care management , care coordination changes, utilization review changes, authorization changes, ... or CERTIFICATIONS** **Required** + None **Preferred** + ACM Certification (Accredited Case Manager ) - American Case Management Association - American Case … more