Full-time (80 hours biweekly)
Weekdays, daytime hours: 8 am to 4:30 pm
Potential limited weekend requirement
**General Summary**
Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of resources to facilitate a patient's progression of care and the provision of appropriate, cost effective and quality health care. Works in a team model with social work in assigned patient care areas to address patient discharge needs. Provides leadership in the integration of utilization and case management principles.
**Essential Functions:**
+ Reviews assigned patients for medical necessity, utilization management, and appropriateness of setting for continued hospitalization.
+ Initiates problem-solving techniques to prevent over and/or under utilization.
+ Facilitates and coordinates the progression of patient care to optimize throughput and the utilization of resources to support continuous quality and cost of care efforts.
+ Liaisons between utilization management team, third party payers, and the treatment team regarding the identified treatment plan in accordance with contractual guidelines and System policy.
+ Assists the patient care team with the identification and coordination of alternative treatment settings to provide appropriate care, maintain quality of care, and reduce cost.
+ Identifies conditions which require case management across the care continuum. Collaborates with members of the patient care team to identify interdisciplinary needs
+ Collaborates with care management across the system to effectively transition patient care and support value-based care initiatives.
+ Completes case management patient assessment, identifies needs, develops a discharge plan, and coordinates discharge needs (DME, Home Health, IV antibiotics, etc.) in collaboration with patients, families, and care team.
+ Assists with the collection and analysis of utilization patterns, length of stay, readmissions, avoidable days, and denied cases.
+ Brings known or suspected problems of under-, over-, or inappropriate utilization of resources to the attention of the appropriate manager(s).
**Common Expectations:**
+ Demonstrates a commitment to patient, visitor, and staff by complying with all applicable safety regulations, learning the impact of medical errors and methodology that will lead to reduction of errors; reporting actual and potential errors, as well as hazardous conditions; identifying opportunities to standardize processes and "error proof" systems that will lead to increased safety; and participating in safety education programs and root cause analyses as required.
+ Prepares and maintains appropriate documentation as required.
+ Maintains established policies and procedures, objectives, quality assessment and safety standards.
+ Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.
+ Prepares and presents utilization data analysis as required.
+ Participates in the development and delivery of educational information and process improvements related to job accountabilities and case management principles.
+ Attends meetings as required.
**Minimum Education:**
+ Associate's Degree Required
+ Bachelor's Degree Preferred
**Work Experience:**
+ 2 years ICU Intensive Care experience preferred
+ Field of Experience in Utilization Management, Case Management, or Clinical Nursing Specialty. Preferred
**Licenses:**
+ Licensed Registered Nurse Upon Hire Required or
+ Registered Nurse Multi State License Upon Hire Required and
+ Basic Life Support Upon Hire Required
+ Certified in Case Management Preferred
**Knowledge, Skills, and Abilities:**
+ Excellent interpersonal and communication skills.
+ Basic computer skills.
+ Desire and ability to work in a supportive and collaborative team environment.
**Benefits Offered:**
+ Comprehensive health benefits
+ Flexible spending and health savings accounts
+ Retirement savings plan
+ Paid time off (PTO)
+ Short-term disability
+ Education assistance
+ Financial education and support, including DailyPay
+ Wellness and Wellbeing programs
+ Caregiver support via Wellthy
+ Childcare referral service via Wellthy
For additional details: Benefits & Incentives | WellSpan Careers (joinwellspan.org) (
WellSpan Health's vision is to reimagine healthcare through the delivery of comprehensive, equitable health and wellness solutions throughout our continuum of care. As an integrated delivery system focused on leading in value-based care, we encompass more than 2,300 employed providers, 250 locations, nine award-winning hospitals, home care and a behavioral health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and one of the best in the nation. With a team 23,000 strong, WellSpan experts provide a range of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions. Our clinically integrated network of 3,000 aligned physicians and advanced practice providers is dedicated to providing the highest quality and safety, inspiring our patients and communities to be their healthiest.
**Quality of Life**
Founded in 1741, the city of York is considered by many as the first capital of the United States. The Articles of Confederation were signed by the Second Continental Congress here in 1777. Its beautifully restored historic district is an architectural treasure. While York retains its farming and manufacturing heritage, at its heart York is a thriving cultural community that has attracted creative talent and innovative entrepreneurial investors from across the nation.
Life in York County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, semi-professional baseball team, fine dining and more - within an easy drive of major East Coast cities.
York County residents can find local employment in healthcare, manufacturing, technology, agricultural and service sectors. (Patient population: 445,000)
WellSpan Health is an Equal Opportunity Employer. It is the policy and intention of the System to maintain consistent and equal treatment toward applicants and employees of all job classifications without regard to age, sex, race, color, religion, sexual orientation, gender identity, transgender status, national origin, ancestry, veteran status, disability, or any other legally protected characteristic.
Weekdays, daytime hours: 8 am to 4:30 pm
Potential limited weekend requirement
**General Summary**
Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of resources to facilitate a patient's progression of care and the provision of appropriate, cost effective and quality health care. Works in a team model with social work in assigned patient care areas to address patient discharge needs. Provides leadership in the integration of utilization and case management principles.
**Essential Functions:**
+ Reviews assigned patients for medical necessity, utilization management, and appropriateness of setting for continued hospitalization.
+ Initiates problem-solving techniques to prevent over and/or under utilization.
+ Facilitates and coordinates the progression of patient care to optimize throughput and the utilization of resources to support continuous quality and cost of care efforts.
+ Liaisons between utilization management team, third party payers, and the treatment team regarding the identified treatment plan in accordance with contractual guidelines and System policy.
+ Assists the patient care team with the identification and coordination of alternative treatment settings to provide appropriate care, maintain quality of care, and reduce cost.
+ Identifies conditions which require case management across the care continuum. Collaborates with members of the patient care team to identify interdisciplinary needs
+ Collaborates with care management across the system to effectively transition patient care and support value-based care initiatives.
+ Completes case management patient assessment, identifies needs, develops a discharge plan, and coordinates discharge needs (DME, Home Health, IV antibiotics, etc.) in collaboration with patients, families, and care team.
+ Assists with the collection and analysis of utilization patterns, length of stay, readmissions, avoidable days, and denied cases.
+ Brings known or suspected problems of under-, over-, or inappropriate utilization of resources to the attention of the appropriate manager(s).
**Common Expectations:**
+ Demonstrates a commitment to patient, visitor, and staff by complying with all applicable safety regulations, learning the impact of medical errors and methodology that will lead to reduction of errors; reporting actual and potential errors, as well as hazardous conditions; identifying opportunities to standardize processes and "error proof" systems that will lead to increased safety; and participating in safety education programs and root cause analyses as required.
+ Prepares and maintains appropriate documentation as required.
+ Maintains established policies and procedures, objectives, quality assessment and safety standards.
+ Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.
+ Prepares and presents utilization data analysis as required.
+ Participates in the development and delivery of educational information and process improvements related to job accountabilities and case management principles.
+ Attends meetings as required.
**Minimum Education:**
+ Associate's Degree Required
+ Bachelor's Degree Preferred
**Work Experience:**
+ 2 years ICU Intensive Care experience preferred
+ Field of Experience in Utilization Management, Case Management, or Clinical Nursing Specialty. Preferred
**Licenses:**
+ Licensed Registered Nurse Upon Hire Required or
+ Registered Nurse Multi State License Upon Hire Required and
+ Basic Life Support Upon Hire Required
+ Certified in Case Management Preferred
**Knowledge, Skills, and Abilities:**
+ Excellent interpersonal and communication skills.
+ Basic computer skills.
+ Desire and ability to work in a supportive and collaborative team environment.
**Benefits Offered:**
+ Comprehensive health benefits
+ Flexible spending and health savings accounts
+ Retirement savings plan
+ Paid time off (PTO)
+ Short-term disability
+ Education assistance
+ Financial education and support, including DailyPay
+ Wellness and Wellbeing programs
+ Caregiver support via Wellthy
+ Childcare referral service via Wellthy
For additional details: Benefits & Incentives | WellSpan Careers (joinwellspan.org) (
WellSpan Health's vision is to reimagine healthcare through the delivery of comprehensive, equitable health and wellness solutions throughout our continuum of care. As an integrated delivery system focused on leading in value-based care, we encompass more than 2,300 employed providers, 250 locations, nine award-winning hospitals, home care and a behavioral health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and one of the best in the nation. With a team 23,000 strong, WellSpan experts provide a range of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions. Our clinically integrated network of 3,000 aligned physicians and advanced practice providers is dedicated to providing the highest quality and safety, inspiring our patients and communities to be their healthiest.
**Quality of Life**
Founded in 1741, the city of York is considered by many as the first capital of the United States. The Articles of Confederation were signed by the Second Continental Congress here in 1777. Its beautifully restored historic district is an architectural treasure. While York retains its farming and manufacturing heritage, at its heart York is a thriving cultural community that has attracted creative talent and innovative entrepreneurial investors from across the nation.
Life in York County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, semi-professional baseball team, fine dining and more - within an easy drive of major East Coast cities.
York County residents can find local employment in healthcare, manufacturing, technology, agricultural and service sectors. (Patient population: 445,000)
WellSpan Health is an Equal Opportunity Employer. It is the policy and intention of the System to maintain consistent and equal treatment toward applicants and employees of all job classifications without regard to age, sex, race, color, religion, sexual orientation, gender identity, transgender status, national origin, ancestry, veteran status, disability, or any other legally protected characteristic.
Job ID: 486322231
Originally Posted on: 7/22/2025
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