RN Utilization Review jobs in Pittsburgh, PA

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RN NURSE DIRECTOR OF CASE MANAGEMENT / RESOURCE MANAGEMENT
Apple Connections, LLC - Pittsburgh, PA
and build-up the Case Managers and Utilization Review Nurses. The hospital is continually recognized for... Utilzation Review, reimbursement, MSDRGs, DRG, RN $120,000 a year
Sponsored by NurseJobsNationwide.com - 7 days ago
RN Case Manager Hospice
Bethany Hospice - Pittsburgh, PA
years in a row! RN needed for full time hospice case manager field position. Requires at least one year of relevant experience, a current PA RN license, and...
Easily apply
Sponsored by Bethany Hospice - 30+ days ago
Professional Care Manager
UPMC 190 reviews - Pittsburgh, PA
and financial plan for patients, performs overall utilization management, resource management, discharge... performs clinical review on admission and/or...
Sponsored by UPMC - 30+ days ago

RN Utilization Management - AHN

Allegheny Health Network – Corporate - Pittsburgh, PA
a working knowledge of care management, utilization review changes, authorization changes, contract... AHN staff regarding utilization review practice and...
8 days ago - save job - block - email - more...

Case Manager - Medical Mgmt SNP

UPMC 190 reviews - Pittsburgh, PA
needs of the member. Review UPMC Health Plan data for... RN licensure required. Bachelor¿s degree in nursing preferred. Case Manager certification preferred. RN...
12 days ago - save job - block - email - more...

Supervisor Medical Management & Policy - Clinical

Highmark Health - Pittsburgh, PA
Utilization Review. * Develop and implement appropriate audit requirements in order to ensure compliance with all staff activity related to Utilization Review...
Highmark Inc. - 28 days ago - save job - block - email - more...

Precertification UR RN--Flex Full Time

UPMC 190 reviews - Pittsburgh, PA
of experience: Nursing - Experience in utilization review activities. - Previous work with insurance companies, precertifications, authorizations, or reviews...
26 days ago - save job - block - email - more...

Intake Case Manager/Inpatient Rehabilitation

Jefferson Hospital 15 reviews - Pittsburgh, PA
clinical RN acute care experience. Case management experience preferred. Inpatient Rehabilitation, utilization review and care coordination required. Proficient...
Jefferson Regional Medical Center - 13 days ago - save job - block - email - more...

Care Manager - Behavioral Health

Highmark Health - Pittsburgh, PA
the implementation of effective utilization management strategies including: review of appropriateness of... appropriate resource utilization, identification of...
Highmark Inc. - 8 days ago - save job - block - email - more...

(RN) Oncology Nurse Case Manager (Phoenix, AZ or Pittsburgh,...

Cigna 636 reviews - Pittsburgh, PA
performs clinical review of services and coordinates... management policy and procedures. Delivers utilization review services for all inpatient, outpatient, and...
5 days ago - save job - block - email - more...

Sr Professional Care Manager-FT Presby

UPMC 190 reviews - Pittsburgh, PA
and financial plan for patients. Performs overall utilization management, resource management, discharge... Performs clinical review on admission and/or...
12 days ago - save job - block - email - more...

Case Manager-Med Review/UM

UPMC 190 reviews - Pittsburgh, PA
The Case Manager-Medical Review is responsible for utilization review of health plan services and... Conducts admission reviews, concurrent reviews, and...
15 days ago - save job - block - email - more...

Mobile Case Manager - Fayette County

UPMC 190 reviews - Pittsburgh, PA
behavioral, pharmacy, and social needs of the member. Review UPMC Health Plan data for services the member... experience in clinical, utilization management, home...
21 days ago - save job - block - email - more...
Preservice Review Nurse RN, Telecommute M-F Day Schedule
UnitedHealth Group 1,378 reviews - Pittsburgh, PA
Perform utilization and pre-service review using CMS... RN, Registered Nurse, Prior Authorizations, Concurrent Review, Managed Care, Utilization, Utilization...
Sponsored by CareerBuilder - 9 days ago
Nurse Case Manager
Aegis Rehabilitation Consulting Services, Inc. - Pittsburgh, PA
integrating and functions of case management, utilization review and management, vocational assessment and... into the workforce. * Active RN License is required
Easily apply
Sponsored by Aegis Rehabilitation Consulting Services, Inc. - 30+ days ago
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