Nurse Utilization Review jobs in Pittsburgh, PA

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Telephonic Care Advocate. Work from Home.
UnitedHealth Group 1,981 reviews - Pittsburgh, PA
· Managed care or utilization review experience. · Conduct focused utilization reviews effectively and efficiently; Or registered psychiatric nurse....
Sponsored by UnitedHealth Group - 18 days ago
DRG Specialist II
UPMC 279 reviews - Pittsburgh, PA
OR Registered Nurse. OR Certified Registered Nurse Practitioner. The DRG Specialist II reviews clinical documentation within the medical record to ensure that...
Sponsored by UPMC - 30+ days ago
Nurse Supervisor - Cranberry Twnship, PA
RestorixHealth - Township of Cranberry, PA
Registered Nurse, Physician Assistant or Nurse Practitioner experience preferred. Health is currently seeking to hire a full-time, Nurse Supervisor/ Charge...
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Sponsored by RestorixHealth - 27 days ago

Clinical Appeals Coordinator - UPMC Health Plan

UPMC 279 reviews - Pittsburgh, PA
Two years of Health Insurance experience as a Registered Nurse in a Utilization Management/Medical Management role strongly preferred....

Authorization Nurse - UPMC Corporate Services

UPMC 279 reviews - Pittsburgh, PA
Qual criteria appropriately Prior utilization review experience Knowledge of payor reimbursement structure....

Clinical Care Manager - UPMC Health Plan Altoona

UPMC 279 reviews - Pittsburgh, PA
Review member¿s current medication profile; Present or contribute to complex case reviews by the interdisciplinary team summarizing clinical and social history,...

Sr Professional Care Manager - UPMC St Margaret

UPMC 279 reviews - Pittsburgh, PA
Performs clinical review on admission and/or continued stay using Inter. Performs overall utilization management, resource management, discharge planning and...

Care Coordinator

Jefferson Hospital 21 reviews - Pittsburgh, PA
Care facilitation and utilization review experience is preferred. Professional role model utilizing expertise in care management to promote a collaborative...

Authorization Nurse - Casual - UPMC Corporate Services

UPMC 279 reviews - Pittsburgh, PA
Qual criteria appropriately Prior utilization review experience Knowledge of payor reimbursement structure....

CASE MANAGER

Geo Group 213 reviews - Pittsburgh, PA
Attends and acts as advocate or liaison to all client court hearings, school meetings, and reviews. Coordinates and develops appropriate service plans through...

Registered Nurse (RN) Utilization Management Nurse Consultan...

Aetna 481 reviews - Pittsburgh, PA
This role will conduct Utilization Review and Discharge Planning for members admitted to an acute facility. Nursing/Registered Nurse is required (RN)....

Triage Nurse

CorVel 25 reviews - Pittsburgh, PA
Triage Nurse (80%). Strong cost containment background, such as utilization review or managed care also useful....

DRG Specialist II

UPMC 279 reviews - Pittsburgh, PA
OR Registered Nurse. OR Certified Registered Nurse Practitioner. The DRG Specialist II reviews clinical documentation within the medical record to ensure that...
Nurse, Surgical Intensive Care, Hershey, PA, 7p-7:30a (Night...
Penn State Hershey Medical Center 28 reviews - Pittsburgh, PA
Advanced Practice Nurse, Behavioral, Birth, Bone, BSN, Cardiac, Care, Career, Case, Casual, Cath, Clinical Documentation, Clinical Nurse Specialist, Control,...
Sponsored by Penn State Milton S. Hershey Medical Center - 15 days ago
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....
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Sponsored by Bethany Hospice - 30+ days ago

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Company with Nurse Utilization Review jobs
1,981 reviews
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