- CVS Health (Baton Rouge, LA)
- … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. - Applies critical thinking and is knowledgeable ... external constituents in the coordination and administration of the utilization /benefit management function. **Required** **Qualifications** - Licensed… more
- CVS Health (Kenner, LA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function - Gathers clinical information and ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in clinically… more
- CVS Health (Baton Rouge, LA)
- …3+ years of Nursing experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical ... and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in… more
- Guardian Life (Baton Rouge, LA)
- **Position Summary** The RN Clinical Consultant serves as a clinical resource for the investigation and assessment of medical information regarding ... medical reviews and analysis of long-term disability claims. The RN Clinical Consultant identifies restrictions, limitations and duration impacting functional… more
- Ochsner Health (New Orleans, LA)
- …at Ochsner Health and discover your future today!** The Physician Advisor (PA- Utilization Management ) serves as the physician leader in matters relating ... the Interdisciplinary and Post-Acute teams, Payors, Administration and Revenue Cycle) to improve utilization management , sustain quality goals, and act as a … more
- Lincoln Financial (Baton Rouge, LA)
- …a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for ... claims. In this role you will act as a clinical resource for Group Protection benefit specialists and claim...Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's… more
- CVS Health (Baton Rouge, LA)
- …unrestricted state licensure required in state of residence **Preferred Qualifications** Utilization Management review Managed Care experience Client processing ... day. **Position Summary** Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained… more
- CenterWell (Baton Rouge, LA)
- …Director is responsible for building a strong partnership with clinical -operational divisional dyads (Division CMO/Division Ops Leader) on care integration ... and coordinating care to reduce acute and post-acute care utilization . The Divisional Director role is a hybrid with...supervisors. The Divisional Director will also be a key consultant partner to market dyad leaders in understanding and… more
- The Arora Group (Jena, LA)
- …emphasizes recovery goals. 16. Participates in comprehensive performance improvement and utilization management plans to include: * Quality and appropriateness ... units; urgent and emergency mental health care, public health management , case management , collaboration with an interdisciplinary...will work in concert with both facility staff and consultant specialists in various clinical areas. 23.… more
- Elevance Health (Metairie, LA)
- …for general psychiatry cases. **How you will make an impact:** + Conduct peer clinical and/or notes case reviews. + Supports the Medical Management staff ... to members and providers. + Conduct peer to peer clinical reviews with attending physicians or other ordering providers...effectiveness and quality. + Serves as a resource and consultant to other areas of the company. + May… more
- Adecco US, Inc. (Alexandria, LA)
- …dynamic and fast paced environment, ensuring the continuation of pharmacy management 's goals and objectives within the dispensing pharmacy. This pharmacist will ... labeling. 6. Check for appropriateness of therapy through prospective drug utilization review including assessment for appropriateness of therapy, high risk… more