Nurse Utilization Review jobs in Pittsburgh, PA

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Registered Nurse Telephonic - Utilization Review
Maxim Healthcare Services 838 reviews - Pittsburgh, PA
Maxim Healthcare seeking energetic RN’s for new Telephonic, Utilization Review positions with competitive pay. Current Registered Nurse License for the state in...
Sponsored by Maxim Healthcare Services  - 28 days ago
Telephonic Care Advocate. Work from Home.
UnitedHealth Group 2,059 reviews - Pittsburgh, PA
· Managed care or utilization review experience. · Conduct focused utilization reviews effectively and efficiently; Or registered psychiatric nurse....
Sponsored by UnitedHealth Group  - 1 day ago
Care Manager - Utilization Management RN
Highmark Health 7 reviews - Pittsburgh, PA
1 year of Utilization Management experience. Certification in Utilization Management or a related field....
Sponsored by Highmark Health  - 6 days ago

Manager, Care Management

UPMC 291 reviews - Pittsburgh, PA
Reviews performance against Health Plan goals and completes staff evaluations; Utilize evidence based practice to support improvement in care / health /...

Care Manager - Utilization Management RN

Highmark Health 7 reviews - Pittsburgh, PA
1 year of Utilization Management experience. Certification in Utilization Management or a related field....

Retrospective Appeals Nurse

UPMC 291 reviews - Pittsburgh, PA
Maintain collaborative relationships with utilization management and appeal departments at payor organizations....

Manager Case Management

Highmark Health 7 reviews - Pittsburgh, PA
O Develop and implement strategies to improve quality, resource utilization based on data. O Review audit results to assess individual employee and team...

Senior Nurse Reviewer

Tri Rivers Assessment Services Inc - Wexford, PA 15090
Senior Nurse Reviewer. Insurance work – Disability, Workers’ Compensation – Utilization Review and Causality. Engines to accomplish review goals....
Easily apply

Full Time Professional Care Manager

UPMC 291 reviews - Pittsburgh, PA
Currently licensed as professional nurse in the Commonwealth of PA. Performs overall utilization management, resource management, discharge planning and post...

RNAC SL

UPMC 291 reviews - Pittsburgh, PA
Knowledge of State and Federal regulations, Case Mix and Utilization Management Review. Experience as an RNAC preferred and a minimum of one year Long Term Care...

UM Care Manager

UPMC 291 reviews - Pittsburgh, PA
The Utilization Management (UM) Care Manager is responsible for utilization review of health plan services and assessment of member's barriers to care, as well...

Quality Assurance CRNP

Adagio Health - Pittsburgh, PA
Position requires a PA licensed Registered Nurse with CRNP licensure in Women's Health, Family Practice or related specialty....
Easily apply

Case Manager II - Per Diem

HealthSouth Corporation 178 reviews - Pittsburgh, PA
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....
Senior Nurse Reviewer
Tri Rivers Assessment Services Inc - Wexford, PA
Senior Nurse Reviewer. Insurance work – Disability, Workers’ Compensation – Utilization Review and Causality. Engines to accomplish review goals....
Easily apply
Sponsored by Tri Rivers Assessment Services Inc  - 23 hours ago
Orthopedic Nurse Reviewer
Tri Rivers Assessment Services Inc - Wexford, PA
WComp, Disability or Utilization Review work:. Experience in Workers’ Compensation, Disability Insurance, or Utilization Review a must....
Easily apply
Sponsored by Tri Rivers Assessment Services Inc  - 30+ days ago

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Company with Nurse Utilization Review jobs
We have modest goals: Improve the lives of others. Change the landscape of health care. Leave the world a better place than we found it.