- Humana (Baton Rouge, LA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... action. + Minimum one, (1) year of experience in Behavioral Health Nursing (inpatient outpatient, psych, substance...Nursing experience + Previous experience in utilization management with ASAM knowledge + Health Plan… more
- Evolent (Baton Rouge, LA)
- …the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, … more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …activities including but not limited to Utilization Management , Case Management and Disease Management , Population Health and Wellness. Facilitates ... experience in either utilization , case or disease management in a hospital or health plan...certification in a specialty recognized by ABMS required + Behavioral Health : Board Certification in Psychiatry is… more
- Magellan Health Services (Baton Rouge, LA)
- …clinical experience in behavioral health or early childhood mental health , and prior experience in quality management , clinical auditing, or managed care ... hold Masters or Doctoral Degree and be a licensed behavioral health professional. Good organization, time management and verbal and written communication… more
- Highmark Health (Baton Rouge, LA)
- …of clinical, case/ utilization management and/or disease/condition management experience, or provider operations and/or health insurance experience ... health status/severity and clinical needs; and assesses health management needs of the assigned member...clinical care is being provided. **Preferred** + Certification in utilization management or a related field +… more
- Magellan Health Services (Baton Rouge, LA)
- …in healthcare, behavioral health , psychiatric and/or substance abuse health care setting. Strong organization, time management and communication skills. ... Knowledge of utilization management procedures, mental health and substance abuse community resources and providers. Knowledge and experience in inpatient… more
- Highmark Health (Baton Rouge, LA)
- …Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care services, ... utilization , identification of opportunities for referral to a Health Coach/case management , and identification and resolution...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Ochsner Health (Baton Rouge, LA)
- …recognized Diabetes Self- Management Education and Support (DSMES) program for the health system. Works closely with diabetic patients to perform an assessment of ... other groups on topics related to diabetes education, disease prevention and management , and develops health improvement programs. + Recommends pharmacological… more
- Elevance Health (Metairie, LA)
- …chronically ill patients, chronically ill pediatric patients, and patients with IDD. + Home Health , Utilization Management or Case Management experience ... care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs. + Uses motivational… more
- Elevance Health (LA)
- …patients, patients with IDD and patients with special needs is preferred. + Home Health , Utilization Management or Case Management experience strongly ... care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs. + Uses motivational… more