Utilization Review Nurse jobs in Pittsburgh, PA

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Registered Nurse Telephonic - Utilization Review
Maxim Healthcare Services 861 reviews - Pittsburgh, PA
Maxim Healthcare seeking energetic RN’s for new Telephonic, Utilization Review positions with competitive pay. Current Registered Nurse License for the state in...
Sponsored by Maxim Healthcare Services
Senior Nurse Reviewer
Tri Rivers Assessment Services Inc - Wexford, PA
Senior Nurse Reviewer. Insurance work – Disability, Workers’ Compensation – Utilization Review and Causality. Engines to accomplish review goals....
Easily apply
Sponsored by Tri Rivers Assessment Services Inc
OASIS Review Nurse Utilization Review Remote
BAYADA Home Health Care 478 reviews - United States
Review clinical information for appropriateness, congruency and accuracy as it relates to the OASIS and 485 while using the Medicare PPS billing model and CMS...
Sponsored by CareerArc.com

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

Highmark Health 8 reviews - Pittsburgh, PA
Document, process and route requests for services to the nurse reviewer and other departments based on documentation procedures, including review type, clinical...

Intake RN JV

UPMC 293 reviews - Pittsburgh, PA
2 years utilization review experience preferred. UPMC Jefferson Regional Home Health is hiring a full-time Intake RN JV to support the Central Intake Department...

Clinical Appeals Coordinator - UPMC Health Plan

UPMC 293 reviews - Pittsburgh, PA
Two years of Health Insurance experience as a Registered Nurse in a Utilization Management/Medical Management role strongly preferred....

UM Care Manager - UPMC Health Plan

UPMC 293 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...

CDI Specialist - Nurse

LifeCare Hospitals of Pittsburgh - Monroeville Cam... - Monroeville, PA
Must be currently licensed as a Registered Nurse. We have an immediate opportunity for Clinical Documentation Improvement Specialist Nurses....

DRG Specialist

UPMC 293 reviews - Pittsburgh, PA
OR Registered Nurse. OR Certified Registered Nurse Practitioner. The DRG Specialist reviews clinical documentation within the medical record to ensure that all...

Care Coordinator- Full-time

West Penn Hospital 22 reviews - Pittsburgh, PA
Care facilitation and utilization review experience preferred. Maintains a working knowledge of care management, care coordination changes, utilization review...

Professional Care Manager - UPMC Passavant Part-time

UPMC 293 reviews - Pittsburgh, PA
Currently licensed as professional nurse in the Commonwealth of PA. Performs overall utilization management, resource management, discharge planning and post...

Senior Nurse Reviewer

Tri Rivers Assessment Services Inc - Wexford, PA 15090
Senior Nurse Reviewer. Insurance work – Disability, Workers’ Compensation – Utilization Review and Causality. Engines to accomplish review goals....
Easily apply

Care Coordinator- Part-time

Forbes Hospital - Monroeville, PA
Care facilitation and utilization review experience preferred. Maintains a working knowledge of care management, care coordination changes, utilization review...
Health Management Utilization Management Senior Manager
Accenture 3,285 reviews - United States
Strong understanding and experience with Utilization Management services including Pre-Certification/Authorization, Concurrent Review, Capacity Management,...
Sponsored by Accenture
Registered Nurse Case Management
Allied Resources Medical Staffing - Pittsburgh, PA
Case Management RN performs pre-admission, admission and continued stay reviews to assure appropriate status documentation and registration....
Easily apply
Sponsored by Allied Resources Medical Staffing

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Company with Utilization Review Nurse jobs
Accenture is a management consulting, technology services and outsourcing company.