• Utilization Management Nurse Consultant…

    CVS Health (Baton Rouge, LA)
    …practice guidelines. Med Review nurses use specific criteria to authorize procedures/ services or initiate a Medical Director referral as needed. Assists ... a collaborative process to implement, coordinate, monitor and evaluate medical review cases. Applies the appropriate clinical...be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,**… more
    CVS Health (08/01/25)
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  • Medical Benefit Review

    Conduent (Baton Rouge, LA)
    … field?** **Are you eager to learn new skills and help adults in need?** As a ** Medical Benefit Review Services Associate, Region 2,** you will help ... Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100...medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic… more
    Conduent (08/01/25)
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  • VP & Medical Director

    Travelers Insurance Company (Baton Rouge, LA)
    …influences which can impact claim outcomes. Organize and coordinate Travelers' medical review functions. This includes interpreting Federal and State ... regulations and medical guidelines to establish medical ...level included in this posting. To learn more about our comprehensive benefit programs please visit http://careers.travelers.com/life-at-travelers/ benefits /… more
    Travelers Insurance Company (07/25/25)
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  • Sr. Medical Affairs Scientific Director

    Grifols Shared Services North America, Inc (New Orleans, LA)
    …organizations 10. Provides strategic input for business development plans and provide scientific/ medical review for BD opportunities 11. Attends global and ... speaker training meetings, symposia, webinars, standalone meetings, etc 6. Review promotional materials and medical information letters...company bonus pool. We offer a wide variety of benefits including, but not limited to: Medical ,… more
    Grifols Shared Services North America, Inc (06/05/25)
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  • Medical Director, MSK Surgery

    Evolent (Baton Rouge, LA)
    …MSK Surgery is a key member of the Medical leadership team, providing timely medical review of service requests. Oversees the Surgery Field Medical ... + Provides medical direction to the support services review process. Responsible for the quality...Inspector General of the Department of Health and Human Services or the General Service Administration (GSA),… more
    Evolent (05/20/25)
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  • Utilization Management Review Nurse

    AmeriHealth Caritas (LA)
    Medical Director for further review . The reviewer independently applies medical and behavioral health guidelines to authorize services , ensuring they meet ... of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services , ensuring treatment aligns… more
    AmeriHealth Caritas (06/25/25)
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  • Medical Director - Care Plus - Florida

    Humana (Baton Rouge, LA)
    …and will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer based review of moderately complex to ... coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The Medical Director may… more
    Humana (06/28/25)
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  • Medical Director- South Central

    Humana (Baton Rouge, LA)
    …will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to ... coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The Medical Director may… more
    Humana (07/11/25)
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  • Medical Director - Mid West Region

    Humana (Baton Rouge, LA)
    …will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to ... coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The Medical Director may… more
    Humana (05/14/25)
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  • Field Medical Director, Interventional…

    Evolent (Baton Rouge, LA)
    …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in...Inspector General of the Department of Health and Human Services or the General Service Administration (GSA),… more
    Evolent (07/30/25)
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