Nurse Utilization Review jobs in Pittsburgh, PA

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Manager, Utilization Management
Provide department direction and leadership through the Supervisor, Utilization Review. Concurrent review experience....
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Director of Nursing
Western Pennsylvania Home Health Association - Pittsburgh, PA
$75,000 a year
Evaluates own job performance and utilization of resources in planning for professional growth. Reviews and audits patient charts as it pertains to direct...
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RN Office Utilization Review
Staffmark - 3.61,827 reviews - Pittsburgh, PA
Certification in Utilization management or a related field. Responsible for the implementation of effective utilization management strategies including:....
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Care Manager - RN, Utilization Management

Highmark Health - 3.026 reviews - Pittsburgh, PA
1 year of Utilization Management experience. Certification in Utilization Management or a related field....

Telephonic Case Manager

Aetna - 3.91,573 reviews - Pittsburgh, PA 15222 (Strip District area)
Previous workers compensation, case management, utilization review or managed care experience preferred....

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,...

Accredo - Nurse Clinician RN Per Diem - Warrendale, PA

Express Scripts - 3.41,653 reviews - Warrendale, PA
Previous clinical criteria review experience preferred. The Nurse Clinician – RN is responsible for reviewing escalated clinical criteria reviews for providers,...

Case Manager

Aetna - 3.91,573 reviews - Township of Moon, PA
Nursing/Registered Nurse is desired. Click here to review the benefits associated with this position....

Authorization Nurse

UPMC - 3.6370 reviews - Pittsburgh, PA 15203 (Southside Slopes area)
Prior utilization review experience. Are you an experienced nurse? Maintain collaborative relationships with utilization management and departments at payor...

RN-Telephonic Case Manager-Workers Comp

Aetna - 3.91,573 reviews - Pittsburgh, PA 15220
Previous workers compensation, case management, utilization review or managed care experience preferred. Registered Nurse (RN) with active state license. RN....

UM (Utilization Management) Care Manager

UPMC - 3.6370 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...

Care Manager RN

Highmark Health - 3.026 reviews - Pittsburgh, PA
RN (Registered Nurse) license. Certification in utilization management or a related field. Responsible for the implementation of effective utilization...

Quality Improvement

Celtic Healthcare - 3.116 reviews - Pittsburgh, PA
Performs utilization review activities as assigned:. Assigns follow-up review to clinical management staff as needed;...
RN Utilization Review
Staffmark - 3.61,827 reviews - Pittsburgh, PA
Utilization Review experience required. RN with Utilization Review exp. RN (Registered Nurse) license. Certification in utilization management or a related...
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Utilization Review Nurse (Traveler)
Performs utilization review in accordance with all state mandated regulations. Obtains and reviews necessary medical reports and subsequent treatment plan...
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