- Humana (Baton Rouge, LA)
- …require interpretation and independent determination of the appropriate courses of action. The Post - Acute Utilization Management Nurse 2: + Review ... caring community and help us put health first** The Utilization Management Nurse utilizes clinical nursing skills...1 or more years previous clinical experience in a Post - Acute clinical setting such as a SNF,… 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
- 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
- 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
- Intermountain Health (Baton Rouge, LA)
- …and program evaluation. + Develops processes, tools, and policies for appropriate utilization management in collaboration with key stakeholders. + Supports ... and maintains positive relationships with medical staff, administration, hospital personnel, post - acute providers, payors, and other community entities. + Leads… more