RN Utilization Review jobs in Pittsburgh, PA

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Staffing Consultant
Wexford Health 58 reviews - Pittsburgh, PA
Annual review with performance increase. For nearly two decades, Wexford Health has consistently delivered proven staffing expertise and a full range of medical...
Sponsored by Wexford Health Sources, Inc.
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. Must have experience with Acute Care Patients and...
Sponsored by Maxim Healthcare Services
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....
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Sponsored by Tri Rivers Assessment Services Inc

Care Manager - Utilization Management RN

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

Telephonic Care Manager - UPMC Health Plan

UPMC 297 reviews - Pittsburgh, PA
Review members current medication profile; Refers member for Comprehensive Medication Review as appropriate....

Coord, Quality Improvement

UPMC 297 reviews - Pittsburgh, PA
BSN or RN is preferred. Conducting quality of care reviews, coordination of follow up, reporting of the activities and monitoring corrective action plans....

UM Care Manager - UPMC Health Plan

UPMC 297 reviews - Pittsburgh, PA
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...

Telephonic Care Manager - Health Management - UPMC Health Pl...

UPMC 297 reviews - Pittsburgh, PA
Review members current medication profile; Refers member for Comprehensive Medication Review as appropriate....

Utilization Reviewer- Full-time

Forbes Hospital - Monroeville, PA
Maintains a working knowledge of care management, utilization review changes, authorization changes, contract changes, regulatory requirements, etc. Serves as...

CDI Specialist - Nurse

LifeCare Hospitals of Pittsburgh - Monroeville Cam... - Monroeville, PA
RN with bachelor’s degree in a related field. This position provides integration of the patient’s condition with the medical record documentation, facilitates...

Health Manager - UPMC Health Plan

UPMC 297 reviews - Pittsburgh, PA
Utilizes supervision by identifying and reporting to supervisor clinical, utilization and outcomes issues. Performs clinical reviews, service authorization and...

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

Highmark Health 8 reviews - Pittsburgh, PA
Communicate effectively with Utilization Management Staff, providers, other internal and external customers and management....

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,...
Registered Nurse, Utilization Review located in Pittsburgh
Maxim Healthcare Services 865 reviews - Pittsburgh, PA
Must have a minimum of 2 years’ experience within utilization review, good computer skills and Interqual experience is preferred....
Sponsored by Maxim Healthcare Services
Senior Nurse Reviewer
Tri Rivers Assessment Services Inc - Wexford, PA
Insurance work – Disability, Workers’ Compensation – Utilization Review and Causality. Engines to accomplish review goals....
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Sponsored by Tri Rivers Assessment Services Inc

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