Nurse Utilization Review jobs in Pittsburgh, PA

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Telephonic Care Advocate. Work from Home.
UnitedHealth Group 1,880 reviews - Pittsburgh, PA
· Managed care or utilization review experience. · Conduct focused utilization reviews effectively and efficiently; Or registered psychiatric nurse....
Sponsored by UnitedHealth Group - 16 days ago
Nurse Clinician RN (Cross Functional)
Express Scripts 924 reviews - Warrendale, PA
Previous clinical criteria review experience preferred; The Nurse Clinician – RN is responsible for reviewing escalated clinical criteria reviews for providers,...
Sponsored by Express Scripts - 16 days ago
Preservice Review RN - Pittsburgh, PA
UnitedHealth Group 1,880 reviews - Pittsburgh, PA
Perform utilization and concurrent review using Milliman criteria. As a Preservice Review Nurse your duties will include:....
Sponsored by UnitedHealth Group - 7 days ago

Registered Nurse -RN- UM Nurse Consultant

Aetna 450 reviews - Pittsburgh, PA 15219 (Middle Hill area)
Utilization management preferred. You will conduct Utilization Review and Discharge Planning for members admitted to an acute facility....

Registered Nurse (RN) - Utilization Management Nurse Consult...

Aetna 450 reviews - Pittsburgh, PA 15220
Conduct Utilization Review and Discharge Planning for members admitted to an acute facility. Nursing/Registered Nurse (RN) is required....

Preservice Review RN - Pittsburgh, PA

UnitedHealth Group 1,880 reviews - Pittsburgh, PA
Perform utilization and concurrent review using Milliman criteria. As a Preservice Review Nurse your duties will include:....

Clinical Auditor/Analyst

UPMC 263 reviews - Pittsburgh, PA
Responsibilities may involve multiple line of business focused reviews, or ad hoc reviews as needed; Prepayment review of high dollar claims, and prepayment...

Clinical Appeals Coordinator

UPMC 263 reviews - Pittsburgh, PA
Two years of Health Insurance experience as a Registered Nurse in a Utilization Management/Medical Management role strongly preferred....

Case Manager II (Pool)

HealthSouth Corporation - Sewickley, PA - +1 location
The CM II performs ongoing utilization review and acts as a liaison to the payor while assuring that cost effective treatment is provided by the team....

Registered Nurse Telephonic Triage

Maxim Healthcare Services 719 reviews - Sewickley, PA - +1 location
Maxim Healthcare seeking energetic RN’s for new Telephonic, Utilization Review positions with competitive pay. Current Registered Nurse License for the state in...

Telephonic Care Advocate. Work from Home.

UnitedHealth Group 1,880 reviews - Pittsburgh, PA
· Managed care or utilization review experience. · Conduct focused utilization reviews effectively and efficiently; Or registered psychiatric nurse....

Associate Care Management Coordinator

Highmark Health 5 reviews - Pittsburgh, PA
Document, process and route requests for services to the nurse reviewer and other departments based on documentation procedures, including review type, clinical...

Care Manager - Utilization Management RN

Highmark Health 5 reviews - Pittsburgh, PA
1 year of Utilization Management experience. Certification in Utilization Management or a related field....
RN Hospice Case Manager-1 Year RN Exp
Bethany Hospice - Pittsburgh, PA
REGISTERED NURSE CASE MANAGER. Demonstrates expertise in utilization of team members including volunteers and community resources....
Easily apply
Sponsored by Bethany Hospice - 30+ days ago
RN Case Manager
Community LIFE 12 reviews - McKeesport, PA
Working knowledge of utilization review, quality assurance and managed health care concepts. Licensed Registered Nurse in Pennsylvania....
Sponsored by Community LIFE - 30+ days ago

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Company with Nurse Utilization Review jobs
1,880 reviews
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