- Evolent (Baton Rouge, LA)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as... medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all… more
- Magellan Health Services (Baton Rouge, LA)
- …according to medical necessity criteria. General Job Information Title Clinical Reviewer III, Licensed/Remote (Louisiana) Grade 26 Work Experience - ... staff. + Provides training, interpretation and support for QI Clinical Reviewer staff. + Audits and validates... Counselor - Care MgmtCare Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care MgmtCare… more
- Fresenius Medical Center (Baton Rouge, LA)
- …regulations at: https://content.intranet.fmcna.com/regulatory-affairs/wp-content/uploads/sites/46/2019/05/Pre-Licensed- Nurse -50-State- Review ... of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a...transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab… more
- Surgery Care Affiliates (Baton Rouge, LA)
- …work schedules and assignments, and emergency changes in collaboration with the CEO and Clinical Leaders. + Leading peer review for anesthesia at the facility. + ... we make is rooted in seven core values: + Clinical quality + Integrity + Service excellence + Teamwork...by the National Board of Certification and Recertification for Nurse Anesthetists. + Insurable by an appropriate medical… more
- Humana (Baton Rouge, LA)
- …guidance where needed. Follows established guidelines/procedures. **KEY ACCOUNTABILITIES** + Review medical documentation, obtain additional information that may ... community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals....TRICARE, all HGB policies and procedures as well as medical necessity review criteria and privacy requirements… more
- Humana (Baton Rouge, LA)
- …and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis ... independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical ...coding experience to conduct a clinical validation review of the inpatient medical record to… more
- Cardinal Health (Baton Rouge, LA)
- …both scheduled outbound calls and inbound call queue. + Meets regularly with Clinical Supervisor and/or Senior Nurse , Individualized Care to discuss feedback ... who need them-faster.** **_What Individualized Care contributes to Cardinal Health_** Clinical Operations is responsible for providing clinical specialties… more
- Surgery Care Affiliates (Baton Rouge, LA)
- …join our team, they will. Responsibilities Skills and Abilities: + Ability to correlate clinical data with patient's medical and nursing care. + Ability to set ... we make is rooted in seven core values: + Clinical quality + Integrity + Service excellence + Teamwork...your health, well-being, and financial future. Our offerings include medical , dental, and vision coverage, 401k plan with company… more
- Datavant (Baton Rouge, LA)
- …years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or ... realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role… more
- Highmark Health (Baton Rouge, LA)
- …:** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This job performs clinical review and data abstraction of patient records to support ... Preferred + Associate's or Bachelor's Degree in Nursing + 1 year performing medical record review and data abstraction for cardiovascular registries + Proficient… more
- CVS Health (Baton Rouge, LA)
- …Description Summary Coordinates all case management activities with members to evaluate medical needs and to facilitate the overall wellness of members. Develops ... Instructs programs and procedures in compliance with network management and clinical coverage policies. **Required Qualifications** + Must reside in Louisiana in… more
- CenterWell (Baton Rouge, LA)
- …will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review ... Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience,...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Oracle (Baton Rouge, LA)
- …+ Excellent communication, stakeholder engagement, and leadership skills. **Preferred Qualifications:** + Clinical experience as a nurse or physician with a deep ... **Job Description** The Clinical Note AI Agent Product Management Leader will...Gather and analyze information to define product specifications and review design specifications. Envision and communicate product strategy and… more
- BioLife Plasma Services (Baton Rouge, LA)
- …You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife ... of laboratory test results, and donor notification of unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works under the guidance of… more
- IQVIA (Baton Rouge, LA)
- …and dedicated Mobile Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) to deliver in-home clinical services to patients initiating therapy ... **Position Title:** Mobile Nurse (LPN/LVN) - Per Diem, In-Home Services **Location:**...diem role involves traveling to patient residences to perform clinical services such as, but not limited to, phlebotomy,… more
- Datavant (Baton Rouge, LA)
- …Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical necessity and necessity of continued ... necessity criteria and standards of care, along with clinical knowledge and expertise successfully. Ideal candidate should be...to author appeal letter Identification of referrals to the medical director for review + Select appropriate… more
- Fresenius Medical Center (Baker, LA)
- …counseling services to patients as permitted within the scope of their clinical training and state license. + Provides educational and goal directed counseling ... and the patient's family/support persons. + In collaboration with the physician and nurse , participates in the discussion of patient DNR status in the facility to… more
- Humana (Baton Rouge, LA)
- …our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... documentation and communication of medical services and/or benefit administration...of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills,… 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
- CenterWell (Baton Rouge, LA)
- …are excited to offer the role of Virtual Physician Collaborator for CenterWell Medical Group, a new virtual care delivery group within CenterWell Senior Primary ... in care, ensuring timeless access to important medications and solving urgent clinical needs. This Virtual Physician Collaborator shares in our vision to innovate… more