Medical Review Nurse jobs in Pittsburgh, PA

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Full Time Nurse Manager
Human Coalition - Pittsburgh, PA
Hold a current registered nurse or advanced registered nurse license in good standing with the state of Pennsylvania medical board....
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Clinical Nurse - Utilization Management (TO MG05)
Refers all first-level review failures to the SGH or other POC for further review and dispositio. This Clinical Nurse will use MTF-specific Quality Improvement...
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Infusion Nurse – Part Time or Per Diem
Allegheny Health Network Healthcare @ Home - Sharpsburg, PA
Registered Nurse (Infusion). Adherence to Allegheny Health Network policies and procedures regarding medical record documentation and Performance Improvement...
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Utilization Review Crd-Pre Adm - Transplant

UPMC - 375 reviews - Pittsburgh, PA 15213 (North Oakland area)
Are you a Registered Nurse with experience working with insurance authorization? Maintains medical records in accordance with hospital and department policies...

Quality Assurance Coding Specialist II

UPMC - 375 reviews - Pittsburgh, PA 15219 (Middle Hill area)
Review Diagnosis codes submitted internal/external coders/reviewers and the medical record documentation to ensure the recommended diagnosis code and meets...

Manager - Clinical Hepatology & Liver Transplant

UPMC - 375 reviews - Pittsburgh, PA 15213 (North Oakland area)
Provides assignment of patients (pre, waitlist and post-op) to respective nurse coordinators. Are you an experienced nurse with a Masters degree and a...

Clinical Care Manager - Monroeville/Jeanette

UPMC - 375 reviews - Pittsburgh, PA 15219 (Middle Hill area)
Review member's current medication profile; Refer member for Comprehensive Medication Review as appropriate. Identifies members' medical, behavioral, and social...

Clinical Coordinator, Supervisory (RN)

Presbyterian SeniorCare - Oakmont, PA 15139
Graduate of approved Registered Nurse School of Nursing. Monitors nurses' notes, RNP, and care tracker data for accuracy and completeness....

Nurse Clinician Child/Adolescent

UPMC - 375 reviews - Pittsburgh, PA 15213 (North Oakland area)
Monitors psychiatric, medical, psychosocial status of assigned team. Initiates or reviews admission paperwork of all assigned patients....

Clinical Research Nurse

Medix - 49 reviews - Pittsburgh, PA
Meet regularly with the Center Director to review progress and issues on active research projects. Collaborate with the medical director and/or other physicians...

Clinical Nurse Liaison

UPMC - 375 reviews - Pittsburgh, PA 15213 (North Oakland area)
Review patient records and obtain any relevant patient information, assessing for patient appropriateness and medical stability to facilitate a timely admission...

Accredo - Nurse Clinician RN Per Diem - Warrendale, PA

Express Scripts - 1,685 reviews - Warrendale, PA
Previous clinical criteria review experience preferred. The Nurse Clinician – RN is responsible for reviewing escalated clinical criteria reviews for providers,...

OP Nurse Coordinator I (RN) - Urgent Care

UPMC - 375 reviews - Pittsburgh, PA 15237
The Professional Nurse Coordinator is a Registered Nurse is a member of the care delivery team. Current Pennsylvania licensure as a Registered Professional...
Provider Based RN Case Manager - Pittsburgh and Erie, PA
Experience with HEDIS and EMR (electronic medical records). RN, Registered Nurse, Case Manager, Nursing, HEDIS, EMR, Managed Care, Medicare, Pittsburgh, Erie,...
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Clinical Coordinator, Supervisory (RN)
Presbyterian SeniorCare network - Oakmont, PA
Graduate of approved Registered Nurse School of Nursing. Monitors nurses' notes, RNP, and care tracker data for accuracy and completeness....
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