Utilization Review RN jobs in Pittsburgh, PA

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Registered Nurse Telephonic Triage
Maxim Healthcare Services 689 reviews - Pittsburgh, PA
Maxim Healthcare seeking energetic RN’s for new Telephonic, Utilization Review positions with competitive pay. Must have experience with Acute Care Patients and...
Sponsored by Maxim Healthcare Services - 20 days ago
Registered Nurse - RN - Telephonic
Maxim Healthcare Services 689 reviews - Pittsburgh, PA
Participate in Quality Assurance and Utilization review activities, as directed. Current RN License. Maintain accurate and timely patient information, which...
Sponsored by Maxim Healthcare Services - 20 days ago

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

Aetna 435 reviews - Pittsburgh, PA
Conduct Utilization Review and Discharge Planning for members admitted to an acute facility. Click here to review the benefits associated with this position....
6 hours ago - save job - email - more...

Care Manager - Utilization Management RN

Highmark Health 5 reviews - Pittsburgh, PA
Current, valid, unrestricted RN license. 1 year of Utilization Management/Review experience. Certification in Utilization Management or a related field....
3 days ago - save job - email - more...

Care Manager - Behavioral Health

Highmark Health 5 reviews - Pittsburgh, PA
Current, valid, unrestricted RN license. Certification in Utilization Management or a related field. Responsible for the implementation of effective utilization...
22 hours ago - save job - email - more...

Medical Review Clinical Reviewer - Medicare

Novitas RPO - Pittsburgh, PA 15219 (Middle Hill area)
Novitas Solutions is an Equal Opportunity Employer - Minorities/Females/Protected Veterans/Disabled RN, Medical Review, clinical decision making....
8 days ago - save job - email - more...

RN-UM Nurse Consultant

Aetna 435 reviews - Pittsburgh, PA
You will conduct Utilization Review and Discharge Planning for members admitted to an acute facility. Click here to review the benefits associated with this...
46 minutes ago - save job - email - more...

Authorization Nurse - UPMC Corporate Services

UPMC 246 reviews - Pittsburgh, PA
Qual criteria appropriately Prior utilization review experience Knowledge of payor reimbursement structure....
12 days ago - save job - email - more...

Medical Review Clinical Reviewer - Medicare

Novitas Solutions Inc. - Pittsburgh, PA
RN, Medical Review, clinical decision making. Certified Professional Coder/Certified Professional Utilization Reviewer....
15 days ago - save job - email - more...

Case Manager - UPMC Health Plan Quality Improvement

UPMC 246 reviews - Pittsburgh, PA
Valid Pennsylvania RN licensure required. RN license in other states as assigned. Five years of experience in clinical, utilization management, home care,...
3 days ago - save job - email - more...

UM Care Manager - UPMC Health Plan

UPMC 246 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...
17 days ago - save job - email - more...

RN Medical Case Manager

Travelers 62 reviews - Pittsburgh, PA
Perform Utilization Review according to established guidelines. Knowledge of medical causation and relatedness, as well as use of medical treatment protocols...
29 days ago - save job - email - more...
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 - 1 day ago
Registered Nurse - RN - Clinical Quality Manager
Maxim Healthcare Services 689 reviews - Pittsburgh, PA
NCQA experience is required, and knowledge of utilization review and case management is preferred. Successful completion of screening tests for the clinical...
Sponsored by Maxim Healthcare Services - 26 days ago
RN Care Case Manager
ABCBS 13 reviews - United States
$57,900 a year
Utilization Management (Pre-cert./Pre-notification). Experience in case management, home health, critical care, medical/surgical, social work, and discharge...
Sponsored by Arkansas Blue Cross and Blue Shield - 15 days ago

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Company with Utilization Review RN jobs
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