Nurse Utilization Review jobs in Pittsburgh, PA

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Quality /Utilization Management Reviewer - Mars/Warrendale,...
Home Health Quality/UM Reviewers perform home health utilization review activities as assigned:. Review charts for appropriate content, accuracy, completion of...
Registered Nurse - RN - Utilization Management
Participate in Quality Assurance and Utilization review activities, as directed. Active Registered Nurse (RN) licensure in the state in which the Registered...
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RN, Case Manager, Case Mgmt, PRN, Days, RSWH
Current utilization review experience handling commercial insurance cases using Navinet software required. Registered Nurse license, BSN preferred....

Utilization Management/Medical Policy Analyst

Novus Group - Pittsburgh, PA
Utilization Management/Medical Policy AnalystOnePittsburgh’spremierecompanies seeksaUtilization Management/Medical PolicyAnalystfor atemporary-to-hireposition...

Telephone RN Case Manager

Keystone Peer Review - Washington, PA
Minimum 3 years clinical experience in acute care, home health care or combination - AND - 3 years case/utilization management or discharge planning experience...

Clinical Auditor/Analyst (RN) - Quality Assurance & Operatio...

UPMC - 485 reviews - Pittsburgh, PA 15219 (Middle Hill area)
Registered Nurse (RN). Responsibilities may involve multiple line of business focused reviews, or ad hoc reviews as needed;...

ERAS Programmatic Nurse Specialist

UPMC - 485 reviews - Pittsburgh, PA 15213 (North Oakland area)
Current Pennsylvania licensure as a Registered Professional Nurse license. The Programmatic Nurse Specialist, a professional registered nurse, has the authority...

CDI Specialist - Nurse

PA - LifeCare Hospitals of Pittsburgh - Main Campu... - Pittsburgh, PA 15221 (Oakland area)
Must be currently licensed as a Registered Nurse. This position provides integration of the patient’s condition with the medical record documentation,...

Quality /Utilization Management Reviewer - Mars/Warrendale,...

Celtic Healthcare - 30 reviews - Mars, PA
Home Health Quality/UM Reviewers perform home health utilization review activities as assigned:. Review charts for appropriate content, accuracy, completion of...

Clinical Documentation Specialist

Ovation, LLC - Pittsburgh, PA
Knowledge of computer technology, quality assurance activities, DRG, Utilization review highly preferred. May perform retrospective reviews to determine trends...

UM RN Reviewer

UPMC - 485 reviews - Seven Fields, PA 16046
2 years utilization review experience preferred. Clinical expertise, teacher, specialized resource nurse, and/or evidence based practice....

Quality Nurse Consultant - Extensive Travel Required

Wexford Health Sources, Inc. - 122 reviews - Pittsburgh, PA
Annual review with performance increase. Current unrestricted Registered Nurse license required. Fundamental knowledge and skill in utilization of computer...

Utilization Review - Business Support Specialist

Allegheny Health Network (Corporate) - 13 reviews - Pittsburgh, PA
This position is responsible for covering vast roles within the Utilization Review management team that include manging bill processing, downgrades, entry into...
Outpatient RN Supervisor
TCV Community Service - Homestead, PA
Responsible for utilization review and supports MD/CRNP productivity. The Psychiatric Outpatient Nurse Supervisor functions as a Team Leader and Supervisor of...
RN Case Manager
Community LIFE - 20 reviews - Pittsburgh, PA
Working knowledge of utilization review, quality assurance and managed health care concepts. Community LIFE is recruiting an experienced RN who is interested in...

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