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Nurse Utilization Review jobs in Pittsburgh, PA

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Utilization Review / Case Manager RN
Maxim Healthcare Services - 1,171 reviews - Pittsburgh, PA
$24 - $28 an hour
New Registered Nurse Utilization Review openings in Pittsburgh, PA. Seeking RN Case Managers with Utilization Review experience....
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Assisted Living Care Supervisor
The Orchards at Foxcrest - Chester, WV
Registered Nurse (RN) or Licensed Practical Nurse (LPN). Attends meetings with other staff to discuss residents and to participate in infection control,...
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Registered Nurse - RN
Registered Nurse Supervisor. At RiverWoods, we are currently looking for Registered Nurse / RN Supervisors ....
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Telephonic Care Manager (RN) - Special Needs Plan

UPMC - 382 reviews - Pittsburgh, PA 15219 (Middle Hill area)
Present complex members for review by the interdisciplinary team summarizing clinical and social history, healthcare resource utilization, case management...

UM (Utilization Management) Care Manager - Ancillary

UPMC - 382 reviews - Pittsburgh, PA 15219 (Middle Hill area)
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...

Utilization Review Crd-Pre Adm - Transplant

UPMC - 382 reviews - Pittsburgh, PA 15213 (North Oakland area)
UPMC Presbyterian is currently hiring a Utilization Review Coordinator to help support the Transplant Department....

Telephonic Care Manager - Pediatric

UPMC - 382 reviews - Pittsburgh, PA 15219 (Middle Hill area)
Present complex members for review by the interdisciplinary team summarizing clinical and social history, healthcare resource utilization, case management...

Care Coordinator - Care Management - Full Time

Forbes Hospital - 3 reviews - Monroeville, PA
Care facilitation and utilization review experience preferred. Maintains a working knowledge of care management, care coordination changes, utilization review...

Care Manager - RN

Highmark Health - Pittsburgh, PA 15222 (Strip District area)
1 year of Utilization Management experience. Certification in Utilization Management or a related field....

Authorization Nurse (Part-Time)

UPMC - 382 reviews - Pittsburgh, PA 15203 (Southside Slopes area)
Prior utilization review experience. Are you an experienced nurse? Registered Nurse UPMC is an equal opportunity employer....

Care Coordinator - Case Management - Part Time

Canonsburg Hospital - Canonsburg, PA
Care facilitation and utilization review experience preferred. Maintains a working knowledge of care management, care coordination changes, utilization review...

Manager, Quality Improvement - Hedis

Highmark Health - Pittsburgh, PA 15222 (Strip District area)
Conduct performance reviews and ongoing staff development. Conduction of on-site visits and medical record reviews via nurse reviewers to assess the care...

Care Manager - Clinical Appeal Review

Highmark Health - Pittsburgh, PA 15222 (Strip District area)
Responsible for the clinical review of appeals, acute care readmissions, retrospective authorization requests, and medical review of claims....
Registered Nurse (RN)
Logix Guru, LLC - Pittsburgh, PA
Maintain collaborative relationships with utilization management and departments at payor organizations. Ensure clinical review process is followed in order to...
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Registered Nurse (RN) / Licensed Practical Nurse (LPN)
Maxim Healthcare Services - 1,171 reviews - Pittsburgh, PA
$18 - $40 an hour
Current Registered Nurse (RN) or Licensed Practical Nurse (LPN) License for the state in which the nurse practices....
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