Nurse Utilization Review jobs in Pittsburgh, PA

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Nurse Clinician RN (Cross Functional)
Express Scripts 695 reviews - Warrendale, PA
The Nurse Clinician RN is responsible for reviewing... reviews for providers, members and patient client advocates within the Prior Authorization/Utilization...
Sponsored by Express Scripts - 13 days ago
Discharge Care Manager RN - Work from Home
UnitedHealth Group 1,480 reviews - Pittsburgh, PA
delivered. As a Utilization Management Nurse you will be responsible for ensuring proper utilization of... planning and/or utilization review 3 or more years...
Sponsored by UnitedHealth Group - 8 hours ago

Manager Clinical Operations (Telecommute)

UnitedHealth Group 1,480 reviews - Pittsburgh, PA
Monitoring of utilization and quality trends, auditing files for appropriate documentation, conducting clinical case reviews and involvement in committees and...
1 day ago - save job - block - email - more...

Case Manager - Health Plan

UPMC 209 reviews - Pittsburgh, PA
- Review UPMC Health Plan data for services the member has received and identify gaps in care based on clinical standards of care....
1 day ago - save job - block - email - more...

Discharge Care Manager RN - Work from Home

UnitedHealth Group 1,480 reviews - Pittsburgh, PA
As a Utilization Management Nurse you will be responsible for ensuring proper utilization of our health services....
8 hours ago - save job - block - email - more...

UM RN Reviewer

UPMC 209 reviews - Pittsburgh, PA
Fayette Home Care & Hospice is hiring a full-time UM RN Reviewer to help support the NWVNA-FHC HH Administration Department for its Fayette Home Care & Hospice...
1 day ago - save job - block - email - more...

(RN) Mercer Health Advantage Nurse Case Manager (Pittsburgh,...

Cigna 684 reviews - Pittsburgh, PA
Delivers utilization review services when member is in active case management as appropriate. Participates in Mercer Health product and corporate training...
5 days ago - save job - block - email - more...

Care Coordinator

Jefferson Hospital 15 reviews - Pittsburgh, PA
Registered nurse who is proficient in the coordination of care and manages coordination of care in accordance with recognized standards of practice for Care...
Jefferson Regional Medical Center - 1 day ago - save job - block - email - more...

Nurse, Registered-Spec Rx

Giant Eagle 537 reviews - Pittsburgh, PA
The Nurse utilizes clinical skills in a collaborative process to identify and coordinate services to facilitate appropriate healthcare outcomes for Specialty...
12 days ago - save job - block - email - more...

Utilization Review Nurse

Tri Rivers Consulting Services - Wexford, PA 15090
Record review division of a musculoskeletal practice in Wexford is in need of RNs with orthopedic, utilization review and/or medical-legal experience....
Easily apply
10 days ago - save job - block - email - more...

RN-Review and Evaluation of Medical Care and Services-TRAVEL

InGenesis 7 reviews - Pittsburgh, PA 15222 (Strip District area)
RN-Review and Evaluation of Medical Care and Services-Non Direct Care- TRAVEL. HIRING IMMEDIATELY to provide services for the Commonwealth of Pennsylvania Great...
5 days ago - save job - block - email - more...

Onsite Transition Coordinator - Job Share

UPMC 209 reviews - Pittsburgh, PA
Complete an overall review of medical record to determine admission diagnoses, barriers, start discharge plan, assess educational needs....
9 days ago - save job - block - email - more...
Healthcare Provider - (RN) Hospital Case Management - Manage...
Deloitte 1,164 reviews - Pittsburgh, PA
program by helping organizations coordinate the utilization of people, process and technology to improve... or methodologies to review, design and/or implement...
Sponsored by 6FigureJobs - 10 days ago
Supervisor Utilization Management
Healthfirst 69 reviews - United States
provision of Utilization Management functions which include: Pre-Certification, Concurrent Review, as well... Nurse (RN) License , Licensed Practical Nurse (LPN...
Sponsored by TweetMyJobs.com - 1 day ago
Clinical Director
Presbyterian SeniorCare 3 reviews - Oakmont, PA
of the clinical record review and chart audits and... will accomplish objectives and promote maximum utilization of personnel. 3. Identifies staff development...
Sponsored by Presbyterian SeniorCare - 17 hours ago

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Company with Nurse Utilization Review jobs
695 reviews
Express Scripts is a Fortune 25 company and is the largest pharmacy benefit manager in the U.S.
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