Case Manager – Utilization Management

Lehigh Valley Health Network

Case Manager at Lehigh Valley Health Network ensuring appropriate use of hospital resources by reviewing patient admissions. Collaborating with care managers and documenting clinical reviews for compliance.

Posted 6/17/2026full-timeRemote • Pennsylvania • 🇺🇸 United StatesJuniorMid-LevelWebsite

About the role

Key responsibilities & impact

Ensures appropriate use of hospital resources by reviewing patients admitted to the hospital
Provides timely, accurate, and thorough clinical reviews
Develops and implements methods, policies, and procedures to improve departmental efficiency
Works collaboratively with management and peers to facilitate appropriate patient class assignment

Requirements

What you’ll need

Specialized Diploma in nursing
2 years of previous utilization review experience
Knowledge of utilization management as it relates to third party payers
Ability to maintain strict adherence to HIPAA
Ability to work in a team environment
Ability to be attentive to detail
RN - Licensed Registered Nurse_PA - State of Pennsylvania Upon Hire

Benefits

Comp & perks

Health insurance
401(k) matching
Paid time off
Flexible work arrangements
Professional development

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

utilization reviewutilization managementclinical reviews

Soft Skills

collaborationattention to detailteamwork

Certifications

RN - Licensed Registered NurseSpecialized Diploma in nursing