Utilization Review RN jobs in Pittsburgh, PA

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Nurse Clinician RN (Cross Functional)
Express Scripts 924 reviews - Warrendale, PA
Previous clinical criteria review experience preferred; The Nurse Clinician – RN is responsible for reviewing escalated clinical criteria reviews for providers,...
Sponsored by Express Scripts - 18 days ago
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...
Easily apply
Sponsored by Bethany Hospice - 30+ days ago

Preservice Review RN - Pittsburgh, PA

UnitedHealth Group 1,883 reviews - Pittsburgh, PA
Perform utilization and concurrent review using Milliman criteria. RN, registered nurse, Pittsburgh, PA, Prior authorizations, utilization management, united...

Registered Nurse -RN- UM Nurse Consultant

Aetna 450 reviews - Pittsburgh, PA 15219 (Middle Hill area)
Utilization management preferred. You will conduct Utilization Review and Discharge Planning for members admitted to an acute facility....

Registered Nurse (RN) - Utilization Management Nurse Consult...

Aetna 450 reviews - Pittsburgh, PA 15220
Conduct Utilization Review and Discharge Planning for members admitted to an acute facility. Click here to review the benefits associated with this position....

Case Manager II

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

Clinical Appeals Coordinator

UPMC 263 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 Manager - Utilization Management RN

Highmark Health 5 reviews - Pittsburgh, PA
Current, valid, unrestricted RN license. 1 year of Utilization Management experience. Certification in Utilization Management or a related field....

Case Manager II - Pool

HealthSouth Corporation - Sewickley, PA - +1 location
The CM II performs ongoing utilization review and acts as a liaison to the payor while assuring that cost effective treatment is provided by the team....

Utilization Review Nurse

Kelly Services 3,064 reviews - Carnegie, PA 15106
Utilization Review Nurse in Carnegie, PA. RN License Required. Kelly Services is currently seeking a Utilization Review Nurse for one of our top clients in...

Nurse Clinician RN (Cross Functional)

Express Scripts 924 reviews - Warrendale, PA
Previous clinical criteria review experience preferred; The Nurse Clinician – RN is responsible for reviewing escalated clinical criteria reviews for providers,...

Registered Nurse Telephonic Triage

Maxim Healthcare Services 720 reviews - Sewickley, PA - +1 location
Maxim Healthcare seeking energetic RN’s for new Telephonic, Utilization Review positions with competitive pay. Must have experience with Acute Care Patients and...
RN Case Manager Hospice
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...
Easily apply
Sponsored by Bethany Hospice - 30+ days ago
RN Case Manager
Community LIFE 12 reviews - McKeesport, PA
Working knowledge of utilization review, quality assurance and managed health care concepts. The RN Case Manager provides the technical, organizational and...
Sponsored by Community LIFE - 30+ days ago
Preservice Review RN - Pittsburgh, PA
UnitedHealth Group 1,883 reviews - Pittsburgh, PA
Perform utilization and concurrent review using Milliman criteria. RN, registered nurse, Pittsburgh, PA, Prior authorizations, utilization management, united...
Sponsored by UnitedHealth Group - 9 days ago

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Company with Utilization Review RN jobs
924 reviews
Express Scripts is a Fortune 25 company and is the largest pharmacy benefit manager in the U.S.