- Humana (Baton Rouge, LA)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Baylor Scott & White Health (Baton Rouge, LA)
- …and members. **Key Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels. + ... type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- Humana (Baton Rouge, LA)
- …supports the goal to put health first? The Prior Authorization, Registered Nurse , RN , Intern will review prior authorization requests for appropriate ... onsite, field, or remote based opportunities. The Prior Authorization, Registered Nurse , RN , Intern will...experience a plus. + Previous experience in prior authorization, utilization management + Experience working with MCG… more
- Highmark Health (Baton Rouge, LA)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- 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...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- Highmark Health (Baton Rouge, LA)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- 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...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
- Elevance Health (Baton Rouge, LA)
- …will make an impact:** + Serves as a resource for medical management programs. Identifies and recommends revisions to policies/procedures. + Ensures staff adheres ... assist with implementation of cost of care initiatives. + May attend meetings to review UM and/or CM process and discusses facility issues. + Hires, trains, coaches,… more