Utilization Review RN jobs in Pittsburgh, PA

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Registered Nurse, Clinical Consultant - Virtual
Prudential 526 reviews - Pittsburgh, PA
Disability Insurance RN Clinical Consultants will... needs. This is not a Utilization Review position. For candidates with Disability Industry RN, Clinical...
Sponsored by Prudential - 28 days ago
Care Manager - Behavioral Health
Highmark Health - Pittsburgh, PA
the implementation of effective utilization management strategies including: review of appropriateness of... appropriate resource utilization, identification of...
Sponsored by Highmark Health - 13 hours ago

Case Manager - Medical Mgmt SNP

UPMC 188 reviews - Pittsburgh, PA
Three years of experience in a managed care environment preferred. Ability to interact with physicians and other health care professionals in a professional...
5 days ago - save job - block - email - more...

RN Utilization Management - AHN

Allegheny Health Network – Corporate - Pittsburgh, PA
CPR required. Obtains or facilitates acquisitions of urgent/emergent authorizations, continued stay authorizations, and authorizations for post-acute services...
1 day ago - save job - block - email - more...

Case Manager-Med Review/UM

UPMC 188 reviews - Pittsburgh, PA
Three years of experience in nursing. Work experience of 1 year discharge planning preferred. Computer proficiency with Microsoft Office products (knowledge and...
8 days ago - save job - block - email - more...

Precertification UR RN--Flex Full Time

UPMC 188 reviews - Pittsburgh, PA
Familiarity wit Interqual is a plus. Ensures compliance with all HIPPA and appropriate regulatory guidelines....
19 days ago - save job - block - email - more...

Care Manager - Behavioral Health

Highmark Health - Pittsburgh, PA
Bachelor's degree in a field related to licensure. educates providers and members on a proactive basis;. and analyzes qualitative and quantitative data in...
Highmark Inc. - 1 day ago - save job - block - email - more...

(RN) Oncology Nurse Case Manager (Phoenix, AZ or Pittsburgh,...

Cigna 635 reviews - Pittsburgh, PA
Manages a caseload of specialty oncology cases, evaluating the need for alternative services and as appropriate;....
5 days ago - save job - block - email - more...

Supervisor Medical Management & Policy - Clinical

Highmark Health - Pittsburgh, PA
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with...
Highmark Inc. - 21 days ago - save job - block - email - more...

Intake Case Manager/Inpatient Rehabilitation

Jefferson Hospital 15 reviews - Pittsburgh, PA
Inpatient Rehabilitation, utilization review and care coordination required. Minimum 2 year recent clinical RN acute care experience....
Jefferson Regional Medical Center - 6 days ago - save job - block - email - more...

RN-Review and Evaluation of Medical Care and Services-TRAVEL

InGenesis 6 reviews - Pittsburgh, PA 15222 (Strip District area)
Assure appropriate and quality medical care that the Medical Assistance Program is properly billed, and that provider and/or recipient fraud, abuse and waste of...
30+ days ago - save job - block - email - more...

Utilization Management Nurse

Wexford Health Sources, Inc. - Pittsburgh, PA
Graduate of an accredited Nursing Program. Prepare statistical reports for UR and Operations personnel as instructed by the UM Director....
14 hours ago - save job - block - email - more...
Clinical Director
Presbyterian SeniorCare 2 reviews - Oakmont, PA
of the clinical record review and chart audits and... supervises, and terminates clinical staff (OT/PT/ST/RN/SW/HHA) and supervises contract personnel. Ensures...
Sponsored by Presbyterian SeniorCare - 30+ days ago
RN Case Manager Hospice
Bethany Hospice - Pittsburgh, PA
years in a row! RN needed for full time hospice case manager field position. Requires at least one year of relevant experience, a current PA RN license, and...
Easily apply
Sponsored by Bethany Hospice - 30+ days ago
Preservice Review Nurse RN, Telecommute M-F Day Schedule
UnitedHealth Group 1,371 reviews - Pittsburgh, PA
Perform utilization and pre-service review using CMS... RN, Registered Nurse, Prior Authorizations, Concurrent Review, Managed Care, Utilization, Utilization...
Sponsored by CareerBuilder - 2 days ago
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Company with Utilization Review RN jobs
2 reviews
Presbyterian SeniorCare believes that those who have spent a lifetime providing for others deserve the best from us.
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