• Medical Director - Acute

    Humana (Harrisburg, PA)
    …resolution skills. Responsibilities The Medical Director provides medical interpretation and determinations on whether acute inpatient rehabilitation ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
    Humana (11/05/24)
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  • Sr. Professional Care Manager Outcomes Management…

    UPMC (Mechanicsburg, PA)
    …payer authorizations for post- acute care. Documents Freedom of Choice re: post- acute services. + Reviews medical record daily to ensure patient continues ... Performs overall utilization management, resource management, discharge planning and post- acute care referrals and authorizations. Works with multi-disciplinary team… more
    UPMC (09/23/24)
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  • Professional Care Manager Utilization Review Nurse

    UPMC (Hanover, PA)
    …a nonpatient-facing position. This Registered Nurse is responsible for completing medical necessity reviews utilizing Indicia and InterQual criteria for admitted ... processes and use critical thinking skills to document accurate descriptions of the medical need for insurance to approve an inpatient hospital stay. **_ This… more
    UPMC (11/06/24)
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  • Part-time Care Manager (RN) - Float (UPMC…

    UPMC (Harrisburg, PA)
    …to help people. In this role, you will have the opportunity to complete medical necessity reviews, coordinate care of patients within the hospital, and help to ... Performs overall utilization management, resource management, discharge planning and post- acute care referrals and authorizations. Works with multi-disciplinary team… more
    UPMC (09/12/24)
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  • Care Manager (RN) Casual - Case Management (UPMC…

    UPMC (Carlisle, PA)
    …Performs overall utilization management, resource management, discharge planning and post- acute care referrals and authorizations. Works with multi-disciplinary team ... to rotate coverage for major and minor holidays. **Responsibilities:** + Reviews medical record daily to ensure patient continues to meet LOC requirements and… more
    UPMC (08/29/24)
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  • Care Manager (RN) - Float…

    UPMC (Harrisburg, PA)
    …Performs overall utilization management, resource management, discharge planning and post- acute care referrals and authorizations. Works with multi-disciplinary team ... position is eligible for a generous sign-on bonus.** **Responsibilities:** + Reviews medical record daily to ensure patient continues to meet LOC requirements and… more
    UPMC (09/29/24)
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