- Humana (Baton Rouge, LA)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post - acute services (such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Humana (Baton Rouge, LA)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- CVS Health (Baton Rouge, LA)
- …role that primarily supports the Aetna Better Health Plan of Louisiana. This UM ( Utilization Management ) Medical Director will be a "Work from Home" position ... and appeal request. This position is primarily responsible for Utilization Management , including prior authorization as well...review. Cases could focus on inpatient or outpatient services, acute and post acute services,… more
- Humana (Baton Rouge, LA)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management + Utilization management experience in a… more
- Ochsner Health (Baton Rouge, LA)
- …and communicates with the patient, caregiver, multi-disciplinary team members as well as post - acute and third-party payers. Collaborates with the care team to ... Preferred - 3 years of hospital-based experience in discharge planning, case management or utilization review. **Certifications** Required - Current registered… more
- Humana (Baton Rouge, LA)
- …and interpretation skills with 5+ years of experience focusing on quality management , utilization management , discharge planning, rehabilitation services, ... attend Fair Hearings. The clinical scenarios arise from outpatient, post - acute care; acute inpatient; LTC...Clinical Integration, Long Term Services & Supports, and Case Management . The Medical Director, as indicated, could need to… more
- Sharecare (Baton Rouge, LA)
- …of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, efficient, and cost-effective manner while ... the health care team to support appropriate total healthcare management . RD colleague is supervised by an Operations Manager....in the orientation and to take the pre and post -test to review competency during orientation. Yearly competency test… more