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Case Manager - Utilization Management at Lehigh Valley Health Network - ApplyBlast

Case Manager - Utilization Management

Lehigh Valley Health Network

3 days ago

Remote

Full Time

Medior

0 applicants

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About this role

The Case Manager - Utilization Management role at Lehigh Valley Health Network ensures appropriate use of hospital resources by reviewing patient admissions and evaluating their appropriateness using approved criteria. The position involves determining correct patient class assignments to comply with third-party payer requirements and collaborating with various departments to optimize patient care and reimbursement. This remote, full-time position requires a licensed Registered Nurse in Pennsylvania with prior utilization review experience.

Responsibilities

Review patient admissions and evaluate appropriateness using approved criteria
Conduct clinical reviews to assist in patient class decision-making
Develop and implement methods to improve departmental efficiency

Skills

Qualifications

Specialized Diploma in nursingRN - Licensed Registered NurseACM - Accredited Case ManagerACMACCM - Certified Case Manager

About Lehigh Valley Health Network

lvhn.org

Headquarters

Allentown, Pennsylvania, United States

Company Size

10001+ employees

Founded

1899

View Profile

Lehigh Valley Health Network (LVHN) is a not‑for‑profit, integrated medical organization that provides comprehensive health care services to the Lehigh Valley and surrounding regions. LVHN operates hospitals, outpatient and urgent care centers, primary care and specialty practices, and offers advanced programs in areas such as cardiology, oncology, and behavioral health, alongside telehealth and rehabilitation services. The system combines clinical care with research, medical education, and community health initiatives to improve population health across its service area. Patients and partners rely on LVHN for coordinated, patient‑centered care and regional clinical expertise.