Nurse Utilization Review jobs in Pittsburgh, PA

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Registered Nurse Telephonic - Utilization Review
Maxim Healthcare Services 865 reviews - Pittsburgh, PA
Maxim Healthcare seeking energetic RN’s for new Telephonic, Utilization Review positions with competitive pay. Current Registered Nurse License for the state in...
Sponsored by Maxim Healthcare Services
Senior Nurse Reviewer
Tri Rivers Assessment Services Inc - Wexford, PA
Senior Nurse Reviewer. Insurance work – Disability, Workers’ Compensation – Utilization Review and Causality. Engines to accomplish review goals....
Easily apply
Sponsored by Tri Rivers Assessment Services Inc
Registered Nurse, Utilization Review located in Pittsburgh
Maxim Healthcare Services 865 reviews - Pittsburgh, PA
Current Registered Nurse License for the state in which the nurse practices. Must have a minimum of 2 years’ experience within utilization review, good computer...
Sponsored by Maxim Healthcare Services

CDI Specialist - Nurse

LifeCare Hospitals of Pittsburgh - Monroeville Cam... - Monroeville, PA
Must be currently licensed as a Registered Nurse. This position provides integration of the patient’s condition with the medical record documentation,...

Care Coordinator- Full-time

West Penn Hospital 22 reviews - Pittsburgh, PA
Care facilitation and utilization review experience preferred. Maintains a working knowledge of care management, care coordination changes, utilization review...

Associate Care Management Coordinator - Pre-Certification Te...

Highmark Health 8 reviews - Pittsburgh, PA
Document, process and route requests for services to the nurse reviewer and other departments based on documentation procedures, including review type, clinical...

Clinical Appeals Coordinator - UPMC Health Plan

UPMC 297 reviews - Pittsburgh, PA
Two years of Health Insurance experience as a Registered Nurse in a Utilization Management/Medical Management role strongly preferred....

Intake RN JV

UPMC 297 reviews - Pittsburgh, PA
2 years utilization review experience preferred. UPMC Jefferson Regional Home Health is hiring a full-time Intake RN JV to support the Central Intake Department...

Care Manager - Utilization Management RN

Highmark Health 8 reviews - Pittsburgh, PA
1 year of Utilization Management experience. Certification in Utilization Management or a related field....

Clinical Compliance Supervisor

UPMC 297 reviews - Pittsburgh, PA
Develop and preforms education for Utilization functions and clinical operations related to audit findings, reviews and ADR's....

Clinical Care Manager - UPMC Heath Plan (Based at UPMC St Ma...

UPMC 297 reviews - Pittsburgh, PA
Review member's current medication profile; Present or contribute to complex case reviews by the interdisciplinary team summarizing clinical and social history,...

DRG Specialist

UPMC 297 reviews - Pittsburgh, PA
OR Registered Nurse. OR Certified Registered Nurse Practitioner. The DRG Specialist reviews clinical documentation within the medical record to ensure that all...

Care Coordinator- Part-time

Forbes Hospital - Monroeville, PA
Care facilitation and utilization review experience preferred. Maintains a working knowledge of care management, care coordination changes, utilization review...
RN Hospice Case Manager-1 Year RN Exp
Bethany Hospice - Pittsburgh, PA
REGISTERED NURSE CASE MANAGER. Demonstrates expertise in utilization of team members including volunteers and community resources....
Easily apply
Sponsored by Bethany Hospice
Orthopedic Nurse Reviewer
Tri Rivers Assessment Services Inc - Wexford, PA
WComp, Disability or Utilization Review work:. Experience in Workers’ Compensation, Disability Insurance, or Utilization Review a must....
Easily apply
Sponsored by Tri Rivers Assessment Services Inc

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