Utilization Review Nurse jobs in Pittsburgh, PA

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Registered Nurse – Case Manager / Utilization Review
Maxim Healthcare Services - 1,472 reviews - Pittsburgh, PA
$26 - $30 an hour
New Registered Nurse Utilization Review openings in Pittsburgh, PA. Participate in Quality Assurance and Utilization review activities, as directed....
Easily apply
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Clinical Operations Specialist
The Orchards - Chester, WV 26034
Registered Nurse (RN). Tracks Medicare customer days and utilization to ensure that the criteria for “skilled services” continues to be met and that...
Easily apply
Sponsored
Registered Nurse-Home Health-Full Time-Afternoon/Evening-Pit...
Allegheny Health Network Healthcare @ Home - Pittsburgh, PA
Review the home health referral, updating & communicating any changes to other disciplines and to customer service center....
Sponsored

Telephonic Care Manager - Special Needs Plan

UPMC - 421 reviews - Pittsburgh, PA 15219 (Middle Hill area)
Present complex members for review by the interdisciplinary team summarizing clinical and social history, healthcare resource utilization, case management...

UM Care Manager (Primarily Weekends - Flexible Full Time Sch...

UPMC - 421 reviews - Pittsburgh, PA 15219 (Middle Hill area)
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...

Care Manager - RN

Highmark Inc - 44 reviews - Pittsburgh, PA 15222 (Strip District area)
RN (Registered Nurse) license. This job implements effective utilization management strategies including:. Review of appropriateness of health care services,...

Clinical Care Manager (RN) - Rare and Chronic Diseases

UPMC - 421 reviews - Pittsburgh, PA 15219 (Middle Hill area)
Review member's current medication profile; Present or contribute to complex case reviews by the interdisciplinary team summarizing clinical and social history,...

Care Coordinator

Jefferson Hospital - 38 reviews - Pittsburgh, PA
Care facilitation and utilization review experience is preferred. Professional role model utilizing expertise in care management to promote a collaborative...

UM RN Reviewer

UPMC - 421 reviews - Seven Fields, PA 16046
2 years utilization review experience preferred. Clinical expertise, teacher, specialized resource nurse, and/or evidence based practice....

Clinical Care Manager - Maternity - Westmoreland County

UPMC - 421 reviews - Pittsburgh, PA 15219 (Middle Hill area)
Review member's current medication profile; Present or contribute to complex case reviews by the interdisciplinary team summarizing clinical and social history,...

Care Manager - Medicare Appeals

Highmark Inc - 44 reviews - Pittsburgh, PA 15222 (Strip District area)
RN (Registered Nurse) license. This job implements effective utilization management strategies including:. Review of appropriateness of health care services,...

Utilization Management Registered Nurse

Wexford Health Sources, Inc. - Pittsburgh, PA
Annual review with performance increase. The Utilization Management Nurse (RN) ensures cost effective outcomes while maintaining a focus on quality care for...

Clinical Implementation Specialist - RNs and Medical Social...

Care Team Solutions LLC - 6 reviews - Pittsburgh, PA
$55,000 - $65,000 a year
A Registered Nurse (RN) OR Medical/Clinical Social Worker. The position will support these Users through regular case reviews and direct communication....
Easily apply
Registered Nurse-Full Time-Weekend-Pittsburgh Area
Allegheny Health Network Healthcare @ Home - Pittsburgh, PA
Review the home health referral, updating & communicating any changes to other disciplines and to the Intake Department....
Sponsored
Registered Nurse - Home Health - Full Time - Pittsburgh Sout...
Allegheny Health Network Healthcare @ Home - Pittsburgh, PA
Review the home health referral, updating & communicating any changes to other disciplines and to customer service center....
Sponsored

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