• RN - Remote Utilization

    Humana (Baton Rouge, LA)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (01/08/25)
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  • Clinical Registered Nurse

    Sharecare (Baton Rouge, LA)
    …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...the disease management program intervention guidelines. An RN is supervised by an Operations Manager (OM). All… more
    Sharecare (01/08/25)
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  • Pre-Authorization Registered Nurse

    Humana (Baton Rouge, LA)
    …professional onsite, field, or remote based opportunities. The Prior Authorization, Registered Nurse , RN , Intern will utilize Humana's Medicaid training ... the goal to put health first? The Prior Authorization, Registered Nurse , RN , Intern will...experience a plus. + Previous experience in prior authorization, utilization management + Experience working with MCG… more
    Humana (01/08/25)
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  • Care Manager RN - Weekends ( Remote

    Highmark Health (Baton Rouge, LA)
    …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
    Highmark Health (01/07/25)
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  • RN Clinical Consultant, Claims Shared…

    Guardian Life (Baton Rouge, LA)
    …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...plan and length of disability. Plan for ongoing case management through proactive partnering with treating providers to move… more
    Guardian Life (12/20/24)
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  • Care Manager Behavioral Health - Part Time…

    Highmark Health (Baton Rouge, LA)
    … - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... Experience in a clinical setting **Preferred** + Certification in utilization management or a related field +...and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** +… more
    Highmark Health (12/12/24)
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  • Licensed Behavioral Health UM

    Humana (Baton Rouge, LA)
    …community and help us put health first** The Licensed Behavioral Health Utilization Management Professional 2 utilizes behavioral health knowledge and skills ... medical services and/or benefit administration determinations. The Licensed Behavioral Health Utilization Management Professional 2 work assignments are varied… more
    Humana (01/08/25)
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