Utilization Review RN jobs in Pittsburgh, PA

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Registered Nurse (RN), Utilization Review -- Relocation to A...
Lovelace Medical Center - United States
RN. Valid NM RN License or valid multi-state compact license. Responsible for applying professional clinical skills and expertise in the utilization review of...
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Nurse Manager /Program Director, PA
RestorixHealth 12 reviews - McKeesport, PA
Supervisory expience, acute care experience, RN or BSN preferred:. Review retrospectively monthly outcome report(s) and collaborates with RXH/Hospital Partner...
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Behavioral Care Advocate - Telecommute Pennsylvania or Delaw...
UnitedHealth Group 2,436 reviews - Pittsburgh, PA
Managed care or utilization review experience. Conduct focused utilization reviews effectively and efficiently;...
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Care Coordinator

Allegheny Health Network (Corporate) 2 reviews - Pittsburgh, PA
Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory...

Authorization Nurse

UPMC 340 reviews - Pittsburgh, PA 15203 (Southside Slopes area)
Prior utilization review experience. Maintain collaborative relationships with utilization management and departments at payor organizations....

Telephone RN Case Manager

CorVel Corporation 138 reviews - Pittsburgh, PA
Need RN with background in case management for this role (can include hospital case management or an insurance background in utilization review)....

Coord, Quality Improvement

UPMC 340 reviews - Pittsburgh, PA 15219 (Middle Hill area)
BSN or RN is preferred. Conducting quality of care reviews, coordination of follow up, reporting of the activities and monitoring corrective action plans....

Care Manager

Highmark Health 15 reviews - Pittsburgh, PA
Current, valid, unrestricted RN license. Certification in Utilization Management or a related field. Responsible for the implementation of effective utilization...

Medical Review Clinical Reviewer - Medicare

Novitas Solutions Inc. - Pittsburgh, PA
Certified Professional Coder/Certified Professional Utilization Reviewer. Review and analyze pre and post pay complex health care claims from a medical...

Senior Care Manager -Clinical Appeal Review

Highmark Health 15 reviews - Pittsburgh, PA
Current, valid, unrestricted RN license. Responsible for the clinical review of appeals, acute care readmissions, retrospective authorization requests, and...

Manager, Provider Concierge Center (RN) - Corporate Care Man...

UPMC 340 reviews - Pittsburgh, PA 15203 (Southside Slopes area)
Strong overall knowledge of Utilization Review preferred. This position will have direct involvement with a Utilization Review centralization initiative....

Care Coordinator - Behavioral Health - Full Time

Forbes Hospital - Monroeville, PA
Care facilitation and utilization review experience preferred. Serves as a educational resource to all AHN staff regarding utilization review practice and...

Care Coordinator, Full-time

West Penn Hospital 24 reviews - Pittsburgh, PA
Care facilitation and utilization review experience preferred. Maintains a working knowledge of care management, care coordination changes, utilization review...
Nurse Manager - Ambulatory Care
RestorixHealth 12 reviews - Pittsburgh, PA
Supervisory expience, acute care experience, RN or BSN preferred:. RN or BSN preferred, acute care experience, supervisory experience:....
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Company with Utilization Review RN jobs
RestorixHealth specializes in developing and managing comprehensive wound care centers of excellence in conjunction with our partners.