RN Utilization Review jobs in Pittsburgh, PA

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Professional Care Manager
UPMC 188 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 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 - 3 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...
4 days ago - save job - email - more...

Hospice RN/CM Mifflin (FT - Mifflin County)

UPMC 188 reviews - Pittsburgh, PA
is hiring a Full-Time Hospice RN/CM Mifflin to help... programs, orientation, quality assurance, utilization review and performance improvement activities...
1 day ago - save job - email - more...

Case Manager-Med Review/UM

UPMC 188 reviews - Pittsburgh, PA
The Case Manager-Medical Review is responsible for utilization review of health plan services and... Conducts admission reviews, concurrent reviews, and...
11 days ago - save job - email - more...

Clinical Quality Specialist (FT-Infinity-Westlake, OH)

UPMC 188 reviews - Pittsburgh, PA
record reviews specific to the Home Health program. Work in conjunction with the supervisor, program director to determine specific focus of record review...
18 days ago - save job - 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. - 24 days ago - save job - 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 - 9 days ago - save job - email - more...

Precertification UR RN--Flex Full Time

UPMC 188 reviews - Pittsburgh, PA
of experience: Nursing - Experience in utilization review activities. - Previous work with insurance companies, precertifications, authorizations, or reviews...
22 days ago - save job - email - more...

Mobile Case Manager - Fayette County

UPMC 188 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...
17 days ago - save job - 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...
1 day ago - save job - email - more...

Registered Nurse Assessment Coordinator (RNAC)

Baptist Homes 3 reviews - Pittsburgh, PA 15234
the actual MDs and PPS Reviews. Responsible for case... who is in the PPS system. Completes the Utilization Review forms required for Medicare and any contracted...
CareerBuilder - 20 days ago - save job - email - more...
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
Nurse, Lic Practical-Spec Rx
Giant Eagle 506 reviews - Pittsburgh, PA
with tasks to ensure department runs efficiently Review all appropriate service and business metrics and... through inappropriate utilization, dosing or duration...
Sponsored by Giant Eagle - 30+ days ago
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...
Sponsored by Highmark Health - 3 days ago
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