Utilization Review RN jobs in Pittsburgh, PA

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RN Hospice Case Manager-1 Year RN Exp
Bethany Hospice - Pittsburgh, PA
RN licensed in the state. RN needed for full time hospice case manager field position. Demonstrates expertise in utilization of team members including...
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Sponsored by Bethany Hospice - 30+ days ago
Nurse, RN, Med/Surg, Hershey, PA, 7p-7:30a w/ e/o Wknd (Nigh...
Penn State Hershey Medical Center 28 reviews - Pittsburgh, PA
At least one year RN experience. Career, Employment, Jobs, Opening, Shift, Schedule, Staff, Department, Unit, Office, Occupation, Compensation, Salary, Benefits...
Sponsored by Penn State Milton S. Hershey Medical Center - 18 days ago
Nurse, RN, Ambulatory - Hematology / Oncology, RELOCATION AS...
Nemours 53 reviews - Pittsburgh, PA
Current and valid RN license in the state of Florida required. Career, Employment, Jobs, Opening, Occupation, Compensation, Salary, Hospital, Health Care,...
Sponsored by Nemours - 11 days ago

Authorization Nurse - UPMC Corporate Services

UPMC 279 reviews - Pittsburgh, PA
Qual criteria appropriately Prior utilization review experience Knowledge of payor reimbursement structure....

Authorization Nurse - Casual - UPMC Corporate Services

UPMC 279 reviews - Pittsburgh, PA
Qual criteria appropriately Prior utilization review experience Knowledge of payor reimbursement structure....

Clinical Appeals Coordinator - UPMC Health Plan

UPMC 279 reviews - Pittsburgh, PA
Create correspondence for review prior to finalizing ¿ outreach to members and/or providers as needed to obtain and review additional clinical documentation....

Care Coordinator

Jefferson Hospital 21 reviews - Pittsburgh, PA
Care facilitation and utilization review experience is preferred. Current PA RN license required. Minimum 2+ years of recent clinical RN acute care experience...

Care Manager

Value Options 142 reviews - Trafford, PA
Applies utilization management policies and procedures for determination of initial, concurrent and retrospective review....

Registered Nurse (RN) Utilization Management Nurse Consultan...

Aetna 484 reviews - Pittsburgh, PA
This role will conduct Utilization Review and Discharge Planning for members admitted to an acute facility. Click here to review the benefits associated with...

Nurses, BSN, Nights, Relocate: Georgetown Univ. Hospital RN...

MedStar Georgetown University Hospital 105 reviews - Pittsburgh, PA 15251 (North Oakland area)
Advanced Practice Nurse, Behavioral, Birth, Bone, BSN, Cardiac, Care, Career, Case, Casual, Cath, Clinical Documentation, Clinical Nurse Specialist, Control,...

Utilization Reviewer- FH

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

Triage Nurse

CorVel 25 reviews - Pittsburgh, PA
Strong cost containment background, such as utilization review or managed care also useful. Review Claim Files and provide assessment....

Medical Review Clinical Reviewer

Novitas Solutions 34 reviews - Pittsburgh, PA 15219 (Middle Hill area)
Certified Professional Coder/Certified Professional Utilization Reviewer. Review and analyze pre and post pay complex health care claims from a medical...
Manager, Provider Concierge Center (RN) - UPMC Corporate Ser...
UPMC 279 reviews - Pittsburgh, PA
Five (5) years experience in utilization review preferred. Understanding of clinical and authorization/utilization review processes....
Sponsored by UPMC - 19 days ago
Triage Nurse
CorVel 25 reviews - Pittsburgh, PA
Strong cost containment background, such as utilization review or managed care also useful. Review Claim Files and provide assessment....
Sponsored by CorVel - 28 days ago

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Company with Utilization Review RN jobs
279 reviews
UPMC develops and delivers Life Changing Medicine through the power of technology, science, and innovation.