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Utilization Review Manager jobs in Pittsburgh, PA

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Utilization Review / Case Manager RN
Maxim Healthcare Services - 1,171 reviews - Pittsburgh, PA
$24 - $28 an hour
Seeking RN Case Managers with Utilization Review experience. New Registered Nurse Utilization Review openings in Pittsburgh, PA....
Easily apply
Sponsored
Manager Financial Investigation &Provider Review (Hospital A...
Highmark Health - Pittsburgh, PA
3 years' of experience in fraud, waste & abuse (FWA) related investigations, utilization review payment or hospital reimbursement....
Sponsored
Manager Pharmacy Services - State Medicaid Managed Care
Highmark Health - Pittsburgh, PA
$90,000 - $130,000 a year
Establishment of drug utilization review programs/development of prior authorization protocols/safety and management edits to drive positive quality outcomes...
Sponsored by TheLadders.com

Team Manager, IT - Pega

Highmark Health - Pittsburgh, PA 15222 (Strip District area)
Conducts performance reviews and assesses, manages performance. Assigns, monitors, and reviews progress and accuracy of work....

Team Manager, IT - Main Frame

Highmark Health - Pittsburgh, PA
Conducts performance reviews and assesses, manages performance. Assigns, monitors, and reviews progress and accuracy of work....

Mgr, CRP Compl&Prov Educ

UPMC - 382 reviews - Pittsburgh, PA 15213 (North Oakland area)
MLP and Resident utilization optimization. Review, modify, and prepare Compliance Office educational tools such as annual mandatory uLearn online compliance...

Associate Relationship Manager - Business Banking

PNC Bank - 2,335 reviews - Pittsburgh, PA  +1 location
101363 Assoc Relationship Mgr - BB. Effectively executes on contact management strategy through utilization of available tools and resources....

RBAC Manager

Grant Thornton - 192 reviews - Pittsburgh, PA 15212 (Perry South area)
Operations, resources utilization and performance. Grant Thornton is seeking a Manager. As part of our team, the Manager....

Team Manager, IT - Testing Services

Highmark Health - Pittsburgh, PA 15222 (Strip District area)
Conducts performance reviews and assesses, manages performance. Assigns, monitors, and reviews progress and accuracy of work....

Certified Case Manager

HealthSouth - 240 reviews - Pittsburgh, PA
The CCM performs ongoing utilization review and acts as a liaison to the payor while assuring that cost effective treatment is provided by the team....

Care Manager - Clinical Appeal Review

Highmark Health - Pittsburgh, PA 15222 (Strip District area)
Responsible for the clinical review of appeals, acute care readmissions, retrospective authorization requests, and medical review of claims....

Director of Utilization Management

Psych Pros Inc - Pittsburgh, PA
National Recruiting Manager. Director/Manager of Utilization Management*. Oversees organization wide Utilization Management Committee....
Easily apply

RN Case Manager Utilization Review

Logix Guru, LLC. - Pittsburgh, PA
Maintain current knowledge of regulatory guidelines related to authorizations.Serve as a liaison between care managers and payors and facilitates payor...
Easily apply
Director of Utilization Management
Psych Pros Inc - Pittsburgh, PA
National Recruiting Manager. Director/Manager of Utilization Management*. Oversees organization wide Utilization Management Committee....
Easily apply
Sponsored
Director of Corporate Risk
Pressley Ridge - Pittsburgh, PA
Facilitate the utilization of internal and external loss-prevention/control services; Review the organization’s loss history processes, developing trend data,...
Easily apply
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