- AmeriHealth Caritas (Lafayette, LA)
- …in a fast-paced, high-volume utilization review environment. **Licensure:** + An active Registered Nurse ( RN ) license in Louisiana or multi state license ... **Role Overview:** Under the direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity for inpatient and outpatient services,… more
- Humana (Baton Rouge, LA)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a… more
- CVS Health (Baton Rouge, LA)
- …+ Active and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC ... experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal… more
- 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- Cognizant (Baton Rouge, LA)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- AmeriHealth Caritas (LA)
- **Role Overview:** Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical ... to 2 weekends per year **Education & Experience** + Registered Nurse candidates: Associate Degree in Nursing...and American Society of Addiction Medicine (ASAM) criterion + Utilization management experience within a managed care… more
- CenterWell (Baton Rouge, LA)
- …clinical experience. + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Intelligence + ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...Experience with Home Health preferred + Previous experience in utilization management within Insurance industry a plus… more
- Ochsner Health (New Orleans, LA)
- …discharge plans based on patient's individualized needs. Registered Nurse ( RN ) Case Manager - Case Management OMC Jefferson Highway PRN To perform ... experience in discharge planning, case management or utilization review. **Certifications** Required - Current registered ...or utilization review. **Certifications** Required - Current registered nurse license in state of practice.… more
- US Tech Solutions (LA)
- …a hospital setting in a specialty area of the nursing field providing utilization management prior authorization reviews. Build strong direct relationships with ... as indicated by staffing and business needs. **Duties:** + ** Registered Nurse with current license in LA...nursing experience with a minimum of 1 year in utilization management / prior authorization review experience. **Experience**… more