- Centene Corporation (Baton Rouge, LA)
- …needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to… more
- Cognizant (Baton Rouge, LA)
- …and retro-authorization as well as timely filing deadlines and processes. + Review clinical denials including but not limited to referral, preauthorization, ... determinations to the Health Plan/Medical Director based on the review of clinical documentation in accordance with...have to be considered** + Educational background - Registered Nurse (RN) + 2-3 years combined clinical … more
- CVS Health (Baton Rouge, LA)
- …Utilization Management Nurse Consultant (UMNC) for NICU Concurrent Review conducts high-acuity, timely, and comprehensive clinical reviews for neonatal ... regulatory compliance and organizational goals. **Key Responsibilities:** * Perform concurrent clinical reviews of NICU admissions for...a compact license. * Minimum 5 years of recent clinical experience. * Working knowledge of UM review… more
- Oracle (Baton Rouge, LA)
- …(ECD) alignments, Critical Care workflow implementation, Multi-Disciplinary Rounding, and various nurse chart review and documentation optimizations. The ideal ... of analysts providing support for operationally required changes and enhancements to clinical applications, and aa group of analysts leading projects that will… more