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Nurse Utilization Review jobs in Pittsburgh, PA

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Utilization Review / Case Manager RN
Maxim Healthcare Services - 1,168 reviews - Pittsburgh, PA
$24 - $28 an hour
New Registered Nurse Utilization Review openings in Pittsburgh, PA. Seeking RN Case Managers with Utilization Review experience....
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Assisted Living Care Supervisor
The Orchards at Foxcrest - Chester, WV
Registered Nurse (RN) or Licensed Practical Nurse (LPN). Attends meetings with other staff to discuss residents and to participate in infection control,...
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Nursing Director, Quality and Risk
Nealy Pierce, LLC - Pittsburgh, PA
The Director will support physician quality through the medical peer review process, and ensure federal, state and regulatory requirements are met on a...
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Manager, Quality Improvement - Hedis

Highmark Health - Pittsburgh, PA 15222 (Strip District area)
Conduct performance reviews and ongoing staff development. Conduction of on-site visits and medical record reviews via nurse reviewers to assess the care...

Telephonic Care Manager (RN) - Special Needs Plan

UPMC - 381 reviews - Pittsburgh, PA 15219 (Middle Hill area)
Present complex members for review by the interdisciplinary team summarizing clinical and social history, healthcare resource utilization, case management...

Care Manager - RN

Highmark Health - Pittsburgh, PA 15222 (Strip District area)
1 year of Utilization Management experience. Certification in Utilization Management or a related field....

Nurse, Lic Practical-Spec Rx

Giant Eagle, Inc. - 1,247 reviews - Pittsburgh, PA
Licensed Practical Nurse. Review all appropriate service and business metrics and assist team on action plans to improve outcome....

Registered Nurse Assesment Coordinator (RNAC)

UPMC - 381 reviews - Pittsburgh, PA 15217 (Squirrel Hill South area)
Participate in Department of Health surveys, utilization management review process, communicating effectively with regulatory and field operation...

Care Manager - Clinical Appeal Review

Highmark Health - Pittsburgh, PA 15222 (Strip District area)
Responsible for the clinical review of appeals, acute care readmissions, retrospective authorization requests, and medical review of claims....

Manager Case Mgt / Clinical Documentation - Full Time

Canonsburg Hospital - Canonsburg, PA
Coordinates, promotes, provides and directs the on-going Case Management and Utilization review processes to assure effectiveness and efficiency of patient care...

Utilization Review Crd-Pre Adm - Transplant

UPMC - 381 reviews - Pittsburgh, PA 15213 (North Oakland area)
UPMC Presbyterian is currently hiring a Utilization Review Coordinator to help support the Transplant Department....

UM (Utilization Management) Care Manager - Ancillary

UPMC - 381 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...

UM (Utilization Management) Care Manager

UPMC - 381 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 - RN
Registered Nurse Supervisor. At RiverWoods, we are currently looking for Registered Nurse / RN Supervisors ....
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Registered Nurse (RN) / Licensed Practical Nurse (LPN)
Maxim Healthcare Services - 1,168 reviews - Pittsburgh, PA
$18 - $40 an hour
Current Registered Nurse (RN) or Licensed Practical Nurse (LPN) License for the state in which the nurse practices....
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