• Utilization Management Nurse

    CenterWell (Baton Rouge, LA)
    …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
    CenterWell (08/02/25)
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  • Disease Management Nurse

    Sharecare (Baton Rouge, LA)
    …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the… more
    Sharecare (07/12/25)
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  • Infusion Referral Nurse - REMOTE

    Prime Therapeutics (Baton Rouge, LA)
    …Patient Programs. **Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... for work visa or residency sponsorship. **Additional Qualifications** + Registered Nurse ( RN ). + 5...experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Credentialing… more
    Prime Therapeutics (07/24/25)
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  • Case Management Team Educator/Lead - OMC…

    Ochsner Health (New Orleans, LA)
    …Current Licensed Practical Nurse (LPN) license in state of practice or Current Registered Nurse ( RN ) license in state of practice. **Knowledge Skills and ... - 3 years of utilization and/or case management experience with either a LPN license, RN...work from the following areas are not eligible for remote work position_ _: Colorado, California, Hawaii, Illinois, Maryland,… more
    Ochsner Health (08/02/25)
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  • Clinical Health Services Associate Manager

    CVS Health (Baton Rouge, LA)
    …years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + Must have experience using MS Office + Must be willing ... with heart, each and every day. **Position Summary** Fully remote , Monday-Friday 8am - 5pm EST position (shifts may...The Associate Manager is also responsible for oversight of utilization management nurses including the organization and… more
    CVS Health (08/08/25)
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  • Concurrent Review Nurse

    Actalent (New Orleans, LA)
    management , and discharge planning. + Proficiency with InterQual. + Active Compact RN License. + Utilization Management /Concurrent Review experience. + ... Job Title: Review Nurse Job Description The Review Nurse ...successful completion of cases. Essential Skills + Experience in utilization management , concurrent review, prior authorization, … more
    Actalent (08/08/25)
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  • Clinical UM Nurse 2

    CenterWell (Baton Rouge, LA)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... skills to make an impact** **Required Qualifications** + Licensed Registered Compact Nurse license ( RN )...mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or Bachelor's… more
    CenterWell (08/01/25)
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  • Sr. Compliance Auditor

    Ochsner Health (New Orleans, LA)
    …Experience** Required - 10 years of experience in coding, specialized coding, auditing, utilization management , or billing, _OR_ 6 years of experience in ... the Audit and Oversight Committee of the Board of Directors and executive management . Presents conclusions to department and organization management and educates… more
    Ochsner Health (08/08/25)
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