Top 18 Utilization management nurse Jobs in Butler, Pa

RN Case Manager (Full Time)- AHN Wexford
Allegheny Health Network —Wexford, PA
- Full-time
- CPR Certification
- Nursing
- 6 years
RN Care Coordinator, AVH, Full Time
Allegheny Health Network —Natrona Heights, PA
- Full-time
- CPR Certification
- Nursing
- RN License
LPN Case Manager
Allegheny County Pennsylvania —Allegheny County, PA
- $68,200 a year
- Online Application
- Background check
- Skilled nursing facility
- Computer literacy
REGISTERED NURSE -6 MAIN- MED-SURG
Butler Memorial Hospital —Butler, PA
- Part-time
- Acute care
- CPR Certification
- Nursing
Quick Apply
14d
REGISTERED NURSE RN - 6T MED/SURG
Butler Memorial Hospital —Butler, PA
- Part-time
- Acute care
- CPR Certification
- Nursing
Quick Apply
14d
REGISTERED NURSE RN 3 SOUTH GERIATRIC PSYCH WEEKEND PROGRAM
Butler Memorial Hospital —Butler, PA
- Part-time
- CPR Certification
- Nursing
- RN License
Quick Apply
REGISTERED NURSE - EMERGENCY DEPARTMENT
Butler Memorial Hospital —Butler, PA
- Part-time
- CPR Certification
- Nursing
- RN License
Quick Apply
REGISTERED NURSE RN FLOAT POOL (CRITICAL CARE)
Butler Memorial Hospital —Butler, PA
- CPR Certification
- Nursing
- Float pool
Quick Apply
Professional Staff Nurse - Home Health Penn Hills
UPMC —Seven Fields, PA
- $37.00 - $48.21 an hour
- Full-time
- CPR Certification
- Nursing
- RN License
- Mileage reimbursement
- Tuition reimbursement
Home Health RN (Crafton)
UPMC —Seven Fields, PA
- $37.00 - $48.21 an hour
- Full-time
- CPR Certification
- Nursing
- RN License
Professional Staff Nurse - Home Health McKnight
UPMC —Allison Park, PA
- $37.00 - $48.21 an hour
- Full-time
- CPR Certification
- Nursing
- RN License
Professional Staff Nurse - Home Health New Kensington
UPMC —New Kensington, PA
- $37.00 - $48.21 an hour
- Full-time
- CPR Certification
- Nursing
- RN License
Virtual Seasonal Family Nurse Practitioner - NY Licensed
One Medical —New Kensington, PA
- $80 an hour
- Seasonal
- Remote
- Mid-level
- Outpatient experience
- Experience working with children
- Commuter assistance
- Paid parental leave
Quick Apply
Professional Staff Nurse - Home Health West View
UPMC —West View, PA
- $37.00 - $48.21 an hour
- Full-time
- CPR Certification
- Nursing
- RN License
Utilization Management Reviewer
Amerihealth Caritas —United States
- Full-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Paid holidays
- Health insurance
Remote Registered Nurse (RN) | $34/hr
Carenet Health —United States
- $34 an hour
- Weekends as needed
- Remote
- Bilingual
- Nursing
- RN License
- Continuing education credits
- Paid holidays

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utilization management nurse jobs near butler, pa

RN Case Manager (Full Time)- AHN Wexford

Allegheny Health Network -
Wexford, PA

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Job Details

Full-time

Qualifications

CPR Certification
BLS Certification
Patient care

Full Job Description

Company :

Allegheny Health Network

Job Description :

GENERAL OVERVIEW:

This job has responsibility for creating, implementing, and evaluating care plans for patients and their families/caregivers across the health continuum. Incumbents will utilize nationally recognized standards of practice for case management by collaborating with providers, clinical teams, health plans, and external partners while advocating for patients and caregivers in order to align goals and plans. Incumbents will serve as professional role models, utilizing their expertise in care management to promote a collaborative professional environment that optimizes outcomes, engages patients/caregivers in their healthcare, and supports effective resource utilization. Serves as key team members in the management of readmissions, length of stay, ED utilization, and patient/family satisfaction.

ESSENTIAL RESPONSIBILITIES:

Contributes to or completes comprehensive assessment of patients and their families/caregivers, inclusive of clinical/physical needs, social determinants of health, and economic barriers impacting their ability to manage their health. (20%)
Effectively identifies barriers and analyzes situations for assigned patient population, including risk for admission/readmission, external resources, and patient/family capacity in order to determine safe plans for transition and care coordination. (20%)
Coordinates the clinical care with the patient, family, provider(s), and members of the interdisciplinary team. (25%)
Advocates for patients and families through effectively communicating with providers, interdisciplinary team members, payers, and post-acute partners to assure effective outcomes and care. (15%)
Leverage understanding of industry standards to provide applicable education to patients, families, providers, and interdisciplinary team partners including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and limitations, transition planning requirements, length of stay, and resource utilization. (10%)
Actively seeks professional development opportunities through professional certification, mentoring/precepting, and/or participation on department/hospital/system committees. (5%)
Adheres to the policies, procedures, rules, regulations, and requirements of hospitals and other clinical settings. (5%)

QUALIFICATIONS:

Minimum

Bachelor’s Degree in Nursing -OR- Bachelor’s Degree and Nursing Diploma -OR- 6 years of relevant experience in lieu of a degree
3 years in a clinical nursing role
Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC).
Critical thinking and problem solving
Flexibility and adaptability to change
Strong communication and collaboration skills with ability to tailor style according to target audience (providers, peers, clinical team members, patients, families)

Preferred

Nationally recognized Case Management Certification
Transition planning and understanding of community and facility resources
Knowledge of motivational interviewing techniques
BSN

LICENSES or CERTIFICATIONS

Required

None

Preferred

ACM Certification (Accredited Case Manager) - American Case Management Association - American Case Management Association
Case Management - American Board of Occupational Health Nurses (ABOHN) and
Certified Case Manager (CCM)
Commission for Case Manager Certification (CCMC)

Additional Employment Requirements:

CPR – American Heart Association
Act 34 Criminal Background Clearance Certificate
Act 33 Child Abuse Clearance Certificate
Act 73 FBI Fingerprinting Criminal Background Clearance Certificate
Professional Certification within 5 years of start date. Incumbents in role as of 12/1/2022 have until 12/31/2026 to obtain

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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For accommodation requests, please contact HR Services Online at [email protected]

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Refine Your Search

utilization management nurse jobs in butler, pa

RN Case Manager (Full Time)- AHN Wexford

RN Care Coordinator, AVH, Full Time

LPN Case Manager

REGISTERED NURSE -6 MAIN- MED-SURG

REGISTERED NURSE RN - 6T MED/SURG

REGISTERED NURSE RN 3 SOUTH GERIATRIC PSYCH WEEKEND PROGRAM

REGISTERED NURSE - EMERGENCY DEPARTMENT

REGISTERED NURSE RN FLOAT POOL (CRITICAL CARE)

Professional Staff Nurse - Home Health Penn Hills

Home Health RN (Crafton)

Professional Staff Nurse - Home Health McKnight

Professional Staff Nurse - Home Health New Kensington

Virtual Seasonal Family Nurse Practitioner - NY Licensed

Professional Staff Nurse - Home Health West View

Utilization Management Reviewer

Remote Registered Nurse (RN) | $34/hr

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