• The CICM Case Manager is responsible for providing person-centered care management services to eligible members with medical, behavioral health, or social needs. • This role includes outreach, engagement, assessment, care planning, care coordination, service navigation, and ongoing follow-up. • The CICM Care Coordinator maintains an active caseload and works collaboratively with health plans, community partners, service providers, and internal staff to reduce barriers, improve access to services, and support members in achieving their wellness goals.

Title: Clinical Manager, Revenue Cycle CCM Location: Pittsburgh United States Job ID: 7979479750 Status: Full-Time Regular/Temporary: Regular Shift: Day Job Work Arrangement: Remote Facility: Corporate Revenue Cycle Department: Rev Cyc Care Mgmt Union Position: No Salary Range: $ 38.12-65.95 USD Job Description: Purpose: UPMC Corporate Revenue Cycle is hiring a Clinical Manager to join our Care Management Team! This role works Monday through Friday during daylight hours. The position is eligible to work remotely. The Clinical Manager is responsible for the direct oversight of the day-to-day operations of the authorization, denial management, and/or utilization review functions of UPMC Revenue Cycle, involving both clinical and non-clinical staff. The role will also ensure that department operations are functioning optimally, and work distribution and workflow processes are operating efficiently and in accordance with all regulatory guidelines. Additionally, this employee will be responsible for staff development, as well as team attainment of quality and productivity goals. Do you have care management or revenue cycle experience? If so, this could be the next step in your career. Read on and apply today! Responsibilities: - Analyze data for trends and causative factors that promote or impede progression toward expected outcomes. Communicate identified trends to appropriate leadership. - Aggressively manage Denial and Edit resolution processes and make improvements to minimize or eliminate. - Develop a high-performing team by identifying opportunities to enhance their knowledge and skills, providing training and mentoring, and promoting a collaborative team-focused work environment. - Utilize the core values as the basis for management making them part of the recruitment, orientation and training for associates (respect, simplicity, integrity, inventiveness and customer services advocacy. - Prioritize work assignments as needed and adjust staffing to accommodate work volumes; provide guidance and assistance to staff in the completion of difficult duties/responsibilities and resolution of complex issues. - Monitor and support daily staff functions by establishing, maintaining and modifying work standards and productivity/quality tools in all areas related to scope of the Manager's responsibility. - Ensure that all policies, procedures, job descriptions, reports and other documentation are properly maintained and issues addressed as required. - Complete or direct the completion of all necessary human resource documentation and adhere to all human resources expectations. - Assist in the implementation and modification/creation of software to support areas related to scope of responsibility. - Function as a resource person for authorization, denial management and/or utilization review processes. - Assess and respond to organizational and customer needs with innovative programs to ensure customer satisfaction. - Communicate regularly and effectively with subordinates and superiors, regarding the status and condition of the business operation under control of the Manager. - Perform other duties as assigned. - Bachelor's degree in Nursing or other Healthcare related field required. - Pennsylvania State Nursing Licensure required. - Five (5 years' experience in revenue cycle/care management/program development required. - Previous supervisory or management experience preferred. - Ability to build credible and effective relationships with physician leadership. - Strong analytical skills. - Proficient in Microsoft Office Applications and analytical/reporting tools. - Keen understanding of clinical and revenue cycle processes. - Excellent communication and interpersonal skills. - Demonstrated leadership capabilities. - Strong quality/process improvement expertise. - Managed care and third-party payor experience (preferred. - Denial Management experience (preferred. - Understanding of clinical and authorization/utilization review processes (preferred. Licensure, Certifications, and Clearances: - Pennsylvania State Nursing Licensure required - Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran

Title: 106444 - Integrated Case Manager - Registered Nurse Location: Richmond United States Hybrid Job Description: City/State Richmond, VA Work Shift First (Days) Overview: Sentara Health in Bristol, VA is looking to hire an Integrated Case Manager, RN. This is a remote position; however, candidates must reside in Bristol and surrounding areas as travel is required. The Integrated Case Manager is responsible for case management services within the scope of licensure; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum. Performs telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical and behavioral health, social services and long-term services. Identifies members for high-risk complications and coordinates of care in conjunction with the member and health care team. Manages chronic illnesses, co-morbidities, and/or disabilities ensuring cost effective and efficient utilization of health benefits; conducts a gap in care management for quality programs. Assists with the implementation of member care plans by facilitating authorizations/referrals within benefits of structure or extra-contractual arrangements, as permissible. Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plans. Presents cases at case conferences for multidisciplinary focus. Ensure compliance with regulatory, accrediting and company policies and procedures. May assist in problem solving with provider, claims or service issues. Demonstrates the minimum knowledge, skills and abilities to care for the individualized needs of the patient to include physical, psychological, socio-cultural, spiritual and cognitive needs as well as functional abilities including the need for diversified use of such practices. Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. Education: - Associates - Bachelors preferred Certification: - Registered Nurse required Experience: - 3 years of nursing experience required - Managed care preferred - Discharge planning experience preferred Keywords: Talroo- Health, Case Management, Managed Care, Discharge Planning Benefits: Caring For Your Family and Your Career - Medical, Dental, Vision plans - Adoption, Fertility and Surrogacy Reimbursement up to $10,000 - Paid Time Off and Sick Leave - Paid Parental & Family Caregiver Leave - Emergency Backup Care - Long-Term, Short-Term Disability, and Critical Illness plans - Life Insurance - 401k/403B with Employer Match - Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education - Student Debt Pay Down - $10,000 - Reimbursement for certifications and free access to complete CEUs and professional development - Pet Insurance - Legal Resources Plan - Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission "to improve health every day," this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

Resource Manager Location: Atlanta United States Job Description: Resource Manager, Tax Atlanta, GA Business Operations - Corp Operations / Full Time / Hybrid Work with a Top 20 CPA and advisory firm that Accounts for Anything. Aprio has 40 U.S. office locations, as well as international office locations and more than 3,200 team members that speak 60+ languages across the globe. By bringing together proven expertise, deep understanding, and strategic foresight for fast-growing industries, Aprio ensures clients are prepared for wherever life or business may take them. Discover a top-rated culture, vast growth opportunities and your next big career move with Aprio. Join Aprio''s Workforce Optimization team and you will help clients maximize their opportunities. Aprio Advisory Group, LLC is a progressive, fast-growing firm looking for a Resource Manager to join their dynamic team. Join Aprio's Workforce Optimization team to help clients and internal leaders make better, faster decisions about capacity, deployment, and delivery-maximizing opportunity while protecting quality and the people experience. Aprio is a progressive, fast-growing firm looking for a Tax Resource Manager to join its dynamic team. As a Resource Manager at Aprio, you will operate as a strategic partner to Practice Leaders, Engagement Managers, and Talent teams to align demand forecasts, capacity plans, and staffing decisions across onshore and offshore delivery. You will translate data and demand signals into clear options and recommendations, proactively manage constraints, and enable consistent client delivery through disciplined workforce planning. This role strengthens client service continuity and workforce stability by accelerating integration of new business advisory, tax, and accounting professionals into the firm's operating model-standardizing workflows, clarifying ownership, and improving adoption of tools and processes. Responsibilities: Relationship Building with Stakeholders - Partner with practice leadership and operations leads to anticipate near- and mid-term resource needs, ensuring training and adoption plans are built into forecasting and capacity models to enable consistent delivery. - Establish and maintain trusted partnerships with Practice Leaders, Engagement Managers, and Talent partners to enable a coordinated, enterprise view of demand, capacity, and deployment decisions. - Continuously assess demand signals and capacity trends to surface gaps and timing risks early, and drive mitigation plans in advance of peak periods to prevent last-minute staffing disruptions. - Leverage deep knowledge of tax pool practices to make sound, strategic trade-off decisions in ambiguity, balancing client commitments, people experience, and firm priorities. Demand & Supply Coordination - Own day-to-day visibility to open needs and scheduled assignments, validating accuracy and proactively recommending staffing options to protect timelines and service quality. - Provide cross-coverage for the Resource Management team by responding quickly to staffing requests for client engagements, projects, and initiatives, ensuring continuity during peak demand and planned absences. - Standardize forecasting practices and lead process improvements that increase planning accuracy and reduce friction for client service teams. Offshore Delivery Enablement - Advance the firm's offshore delivery strategy by identifying transferable work, sequencing transitions, and maintaining quality, turnaround time, and client experience expectations. - Align with offshore operations to maintain a forward-looking pipeline, capacity view, and weekly staffing roster, enabling earlier decisions and fewer last-minute escalations. - Facilitate staffing discussions with industry leaders, pod leaders, engagement managers, and project leaders to clarify requirements, confirm readiness, and secure timely resourcing decisions. Continuous Improvement - Apply an Agile, test-and-learn approach to adapt quickly to shifting priorities and demand, while maintaining predictable execution through clear routines and cadence. - Define, implement, and reinforce best practices and standard operating procedures for workforce management and delivery to improve consistency, scalability, and client satisfaction. - Strengthen relationships with client service leaders to anticipate change impacts and expand change management partnership opportunities that improve adoption and outcomes. Reporting & Analysis - Monitor timelines, workloads, and utilization to identify conflicts and constraints early, and translate insights into clear recommendations for leaders and engagement teams. - Track, analyze, and communicate resource management KPIs, using trends to drive decisions on staffing, offshore leverage, and process improvements. Quality, Risk & Compliance - Proactively manage allocation risks by proposing realignments, timeline adjustments, and staffing alternatives, escalating early when constraints could impact delivery. - Negotiate timelines, priorities, and assignments using data and stakeholder input to optimize outcomes for clients, teams, and firm-wide utilization goals. Team Collaboration & Partnership - Coordinate with fellow Resource Managers to balance workloads, share capacity, and drive enterprise staffing priorities, ensuring consistent coverage across practices. - Lead and contribute in team meetings, planning discussions, and working sessions by bringing forward risks, options, and decisions needed to keep staffing plans on track. - Resolve resource conflicts through transparent communication and solution-oriented facilitation, aligning stakeholders on trade-offs and next steps. - Document and share best practices, lessons learned, and process enhancements to improve consistency, speed, and decision quality across the Resource Management function. - Execute additional duties within the scope of the role as needed to advance resource management effectiveness and support M&A integration priorities. Qualifications: - Bachelor's degree in business administration, Accounting, Human Resources, or a related field preferred. Professional certification (e.g., RMCP, PMP, SHRM-CP) is a plus. - 5-7+ years of experience in resource management, workforce planning, or operations within professional services (tax/accounting preferred), with demonstrated impact on utilization, capacity planning, and delivery outcomes. - Advanced analytical capability to interpret workforce data, identify leading indicators, and convert insights into clear recommendations and staffing actions. - Strong executive-ready communication and facilitation skills to align stakeholders, negotiate trade-offs, and drive timely decisions. - Proficiency with Power BI (or similar), resource management tools, and Microsoft Office to build repeatable reporting, improve visibility, and enable data-driven planning. - Strong business acumen and enterprise mindset, with the ability to understand practice priorities, client delivery constraints, and the firm's operating model to make balanced recommendations. - Comfortable operating in a fast-paced, deadline-driven environment-prioritizing effectively, establishing planning cadence, and escalating constraints early to protect delivery. - Success in this role requires a team-first mindset and inclusive leadership, strong partnership across client service and talent functions, and a commitment to continuously improving how the firm plans, staffs, and delivers work. Why work for Aprio: Whether you are just starting out, looking to advance into management or searching for your next leadership role, Aprio offers an opportunity to grow with a future-focused, innovative firm. Perks/Benefits we offer for full-time team members: - Medical, Dental, and Vision Insurance on the first day of employment - Flexible Spending Account and Dependent Care Account - 401k with Profit Sharing - 9+ holidays and discretionary time off structure - Parental Leave - coverage for both primary and secondary caregivers - Tuition Assistance Program and CPA support program with cash incentive upon completion - Discretionary incentive compensation based on firm, group and individual performance - Incentive compensation related to origination of new client sales - Top rated wellness program - Flexible working environment including remote and hybrid options What's in it for you: - Working with an industry leader: Be part of a high-growth firm that is passionate for what's next. - An awesome culture: Thirty-one fundamental behaviors guide our culture every day ensuring we always deliver an exceptional team-member and client experience. We call it the Aprio Way. This shared mindset creates lasting relationships between team members and with clients. - A great team: Work with a high-energy, passionate, caring and ambitious team of professionals in a collaborative culture. - Entrepreneurship: Have the freedom to innovate and bring your ideas to help us grow to become the CPA firm of choice nationally. - Growth opportunities: Grow professionally in an environment that fosters continuous learning and advancement. - Competitive compensation: You will be rewarded with competitive compensation, industry-leading benefits and a flexible work environment to enjoy work/life balance. EQUAL OPPORTUNITY EMPLOYER Aprio is an Equal Opportunity Employer encouraging diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race; color; religion; national origin; sex; pregnancy; sexual orientation; gender identity and/or expression; age; disability; genetic information, citizenship status; military service obligations or any other category protected by applicable federal, state, or local law. Aprio, LLP and Aprio Advisory Group, LLC, operate in an alternative business structure, with Aprio Advisory Group, LLC providing non-attest tax and consulting services, and Aprio, LLP providing CPA firm services. We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans.