Utilization Management Nurse jobs in Pittsburgh, PA

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Telephonic Care Advocate. Work from Home.
UnitedHealth Group 2,058 reviews - Pittsburgh, PA
Or registered psychiatric nurse. As a Care Advocate, you are responsible for inbound, queue based case management and utilization review of behavioral health...
Sponsored by UnitedHealth Group  - 30 days ago
Registered Nurse (Home Health): Pittsburgh
Celtic Healthcare - Pittsburgh, PA
Registered Nurse (Home Health). Will also educate the patient/caregiver in the management of their illness and promote the home health support systems to...
Sponsored by Celtic Healthcare  - 30+ days ago
Registered Nurse- Full Time (Home Health) Natrona Heights
Celtic Healthcare - Natrona Heights, PA
Will also educate the patient/caregiver in the management of their illness and promote the home health support systems to decrease re-hospitalization and...
Sponsored by Celtic Healthcare  - 1 day ago

Retrospective Appeals Nurse

UPMC 290 reviews - Pittsburgh, PA
Maintain collaborative relationships with utilization management and appeal departments at payor organizations....

UM Care Manager

UPMC 290 reviews - Pittsburgh, PA
Minimum of 1 year work related experience in Utilization Management required. The Utilization Management (UM) Care Manager is responsible for utilization review...

Quality Assurance CRNP

Adagio Health - Pittsburgh, PA
Position requires a PA licensed Registered Nurse with CRNP licensure in Women's Health, Family Practice or related specialty....
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Team Leader

UPMC 290 reviews - Pittsburgh, PA
Minimum of one (1) year management experience OR project management experience preferred. Facilitates accurate documentation and ensures optimal patient care...

Service Coordinator

Pressley Ridge 42 reviews - Pittsburgh, PA
Ability to evaluate individuals, their service needs and current utilization of services. Regulations and standards for Blended Case Management (Blended Service...

Clinical Care Manager

UPMC 290 reviews - Pittsburgh, PA
1 year of experience in clinical, utilization management, home care, discharge planning, and/or case management preferred....

Clinical Appeals Coordinator

UPMC 290 reviews - Pittsburgh, PA
Two years of Health Insurance experience as a Registered Nurse in a Utilization Management/Medical Management role strongly preferred....

Director, Clinical Programs Medicaid and CHiP

UPMC 290 reviews - Pittsburgh, PA
Analyzes utilization and cost data. Ensures that member self- management strategies and materials are developed using health literacy format and are recovery...

Manager, Care Management

UPMC 290 reviews - Pittsburgh, PA
Utilize evidence based practice to support improvement in care / health / utilization management. UPMC Health Plan is hiring a Full-Time Mgr, Care Management...

Licensed Practical Nurse (Hospice)Full Time PGH

Celtic Healthcare - Pittsburgh, PA
The Licensed Practical Nurse under the supervision of the Nurse Manager and a registered nurse , will administer skilled nursing services within their scope of...
Assistant Director of Nursing Job
HCR ManorCare 754 reviews - Pittsburgh, PA
The position conducts the nursing process – assessment, planning, implementation and evaluation – under the scope of the State's Nurse Practice Act of...
Sponsored by HCR ManorCare  - 2 days ago
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....
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Sponsored by Bethany Hospice  - 3 days ago

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