Nurse Utilization Review jobs in Pittsburgh, PA

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REGISTERED NURSE (Bed Management)
Incumbent will coordinate with Utilization Management and participate in the Prospective Admission Review (PAR) process....
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Registered Nurse (RN), Utilization Review -- Relocation to A...
Lovelace Medical Center - United States
Responsible for applying professional clinical skills and expertise in the utilization review of health care services for patients, coordinating services...
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RN Hospice Case Manager-1 Year RN Exp
Bethany Hospice - 2 reviews - Pittsburgh, PA
REGISTERED NURSE CASE MANAGER. Demonstrates expertise in utilization of team members including volunteers and community resources....
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REGISTERED NURSE (Bed Management)

Department of Veterans Affairs - 1,245 reviews - Pittsburgh, PA
Incumbent will coordinate with Utilization Management and participate in the Prospective Admission Review (PAR) process....

UM Nurse Consultant

Aetna - 624 reviews - Pittsburgh, PA 15220
Conduct Utilization Review and Discharge Planning for members admitted to an acute facility. Nursing/Registered Nurse is required....

Care Coordinator

naviHealth - 18 reviews - 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,...

Care Coordinator

Allegheny Health Network (Corporate) - 2 reviews - Pittsburgh, PA
Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory...

Programmatic Nurse Specialist

UPMC - 341 reviews - Pittsburgh, PA 15232 (Shadyside area)
Current Pennsylvania licensure as a Registered Professional Nurse. The Programmatic Nurse Specialist, a professional registered nurse, has the authority,...

UM Care Manager - Medical Management

UPMC - 341 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...

Registered Nurse Assessment Coordinator (RNAC)/MDS Coordinat...

Carerite Centers - Brackenridge, PA
Responsible for preparing and updating Medicare and HMO information for weekly utilization review as per policy....

Senior Care Manager -Clinical Appeal Review

Highmark Health - 15 reviews - Pittsburgh, PA
Responsible for the clinical review of appeals, acute care readmissions, retrospective authorization requests, and medical review of claims....

Telephone RN Case Manager

CorVel Corporation - 138 reviews - Pittsburgh, PA
Need RN with background in case management for this role (can include hospital case management or an insurance background in utilization review)....

Registered Nurse/Dialysis

Department Of Veterans Affairs - 1,245 reviews - 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...
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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