Nurse Utilization Review jobs in Pittsburgh, PA

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REGISTERED NURSE (Bed Management)
Department of Veterans Affairs - Pittsburgh, PA
Incumbent will coordinate with Utilization Management and participate in the Prospective Admission Review (PAR) process....
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Utilization Review Nurse (Traveler)
Alaska Native Tribal Health Consortium - Pittsburgh, PA
$5.50 an hour
Performs utilization review in accordance with all state mandated regulations. Obtains and reviews necessary medical reports and subsequent treatment plan...
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Clinic RN
Community LIFE - McKeesport, PA
Working knowledge of utilization review, quality assurance and managed health care concepts. At least one year of experience as a Registered Nurse working with...
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UM Nurse Consultant

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

Care Coordinator

naviHealth - Pittsburgh, PA 15219 (Middle Hill area)
Complete Utilization Management functions for authorizations. The health care team includes physicians, health plan UM/CM Nurse, hospital discharge planners,...

Telephone RN Case Manager

CorVel Corporation - Pittsburgh, PA
Need RN with background in case management for this role (can include hospital case management or an insurance background in utilization review)....

Programmatic Nurse Specialist

UPMC - Pittsburgh, PA 15232 (Shadyside area)
Current Pennsylvania licensure as a Registered Professional Nurse. The Programmatic Nurse Specialist, a professional registered nurse, has the authority,...

RN-Review and Evaluation of Medical Care and Services-Non Di...

IG Javier - Pittsburgh, PA
Work may include serving as a team leader on reviews requiring more than one staff member organizing and coordinating the review process....
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Authorization Nurse

UPMC - Pittsburgh, PA 15203 (Southside Slopes area)
Prior utilization review experience. Maintain collaborative relationships with utilization management and departments at payor organizations....

Care Manager - Clinical Appeal Review

Highmark Health - Pittsburgh, PA
Responsible for the clinical review of appeals, acute care readmissions, retrospective authorization requests, and medical review of claims....

REGISTERED NURSE (Bed Management)

Department of Veterans Affairs - Pittsburgh, PA
Incumbent will coordinate with Utilization Management and participate in the Prospective Admission Review (PAR) process....

Senior Care Manager -Clinical Appeal Review

Highmark Health - Pittsburgh, PA
Responsible for the clinical review of appeals, acute care readmissions, retrospective authorization requests, and medical review of claims....

Registered Nurse/Dialysis

Department Of Veterans Affairs - Pittsburgh, PA
$48,927 - $101,797 a year
Practice, ethics and resource utilization; The Dialysis Nurse is accountable to the Nurse Manager, Dialysis section, Medicine Service Line, University Drive...
Nurse Manager - Ambulatory Care
RestorixHealth - Pittsburgh, PA
Registered Nurse, Physician Assistant or Nurse Practitioner experience preferred.\*. The candidate must be a Registered Nurse in the State of Pennsylvania....
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