Provides first level utilization review for all inpatient and outpatient services requiring authorization: Prospective Review Urgent/ Non-urgent, Concurrent Review and Retrospective Review.
Provides first level utilization review for all inpatient and outpatient services requiring authorization: Prospective Review Urgent/ Non-urgent, Concurrent Review and Retrospective Review.
Provides first level utilization review for all inpatient and outpatient services requiring authorization: Prospective Review Urgent/ Non-urgent, Concurrent Review and Retrospective Review.
Provides first level utilization review for all inpatient and outpatient services requiring authorization: Prospective Review Urgent/ Non-urgent, Concurrent Review and Retrospective Review.
Clinical Admissions Therapist (Louisiana)
Baton Rouge, LA ยท Remote
$60K - $70K/yr
Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ... full-time, exempt employees. Read more about our benefits here. Additional Information Note to ...
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Clinical Admissions Therapist (Louisiana)
Baton Rouge, LA ยท Remote
$60K - $70K/yr
Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ... full-time, exempt employees. Read more about our benefits here. Additional Information Note to ...
Compliance Manager
Baton Rouge, LA ยท On-site +1
$77K - $124K/yr
This position is available for remote/WFH within Louisiana, candidates must reside in Louisiana ... NCQA), Utilization Review Accreditation Commission (URAC), federal regulations and state law.
Compliance Manager
Baton Rouge, LA ยท On-site +1
$77K - $124K/yr
This position is available for remote/WFH within Louisiana, candidates must reside in Louisiana ... NCQA), Utilization Review Accreditation Commission (URAC), federal regulations and state law.
Sr. Operations Manager - (Hybrid-Remote)
Baton Rouge, LA ยท On-site +1
... Full-time Description & Requirements Maximus is currently hiring for a Sr. Operations Manager . The ... in relation to reviews and corrections of calls monitored. - Monitor performance goals and ...
Sr. Operations Manager - (Hybrid-Remote)
Baton Rouge, LA ยท On-site +1
... Full-time Description & Requirements Maximus is currently hiring for a Sr. Operations Manager . The ... in relation to reviews and corrections of calls monitored. - Monitor performance goals and ...
Call Center Representative (Healthcare) - Baton Rouge, LA - Remote
Baton Rouge, LA ยท Remote
$29K - $41K/yr
Familiarity with medical claims processing or review preferred What you should expect in this role ... All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a ...
Call Center Representative (Healthcare) - Baton Rouge, LA - Remote
Baton Rouge, LA ยท Remote
$29K - $41K/yr
Familiarity with medical claims processing or review preferred What you should expect in this role ... All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a ...
Call Center Representative (Healthcare) - Baton Rouge, LA - Remote
Baton Rouge, LA ยท On-site +1
$29K - $41K/yr
Familiarity with medical claims processing or review preferred What you should expect in this role ... All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a ...
Call Center Representative (Healthcare) - Baton Rouge, LA - Remote
Baton Rouge, LA ยท On-site +1
$29K - $41K/yr
Familiarity with medical claims processing or review preferred What you should expect in this role ... All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a ...
Call Center Representative - Baton Rouge, LA - Remote
Baton Rouge, LA ยท On-site +1
$29K - $41K/yr
Familiarity with medical claims processing or review preferred What you should expect in this role ... All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a ...
Call Center Representative - Baton Rouge, LA - Remote
Baton Rouge, LA ยท On-site +1
$29K - $41K/yr
Familiarity with medical claims processing or review preferred What you should expect in this role ... All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a ...
Call Center Representative - Baton Rouge, LA - Remote
Baton Rouge, LA ยท Remote
$29K - $41K/yr
Familiarity with medical claims processing or review preferred What you should expect in this role ... All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a ...
Call Center Representative - Baton Rouge, LA - Remote
Baton Rouge, LA ยท Remote
$29K - $41K/yr
Familiarity with medical claims processing or review preferred What you should expect in this role ... All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a ...
RN, DRG Coder / Clinical Auditor
Baton Rouge, LA ยท Remote
$95K - $105K/yr
... ๐ Remote | Full-Time | ๐ฅ Healthcare | Clinical Documentation & Coding About the Role We're seeking a detail-oriented DRG Coder/Clinical Auditor to perform DRG validation reviews of medical ...
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RN, DRG Coder / Clinical Auditor
Baton Rouge, LA ยท Remote
$95K - $105K/yr
... ๐ Remote | Full-Time | ๐ฅ Healthcare | Clinical Documentation & Coding About the Role We're seeking a detail-oriented DRG Coder/Clinical Auditor to perform DRG validation reviews of medical ...
Office Operations (French Bilingual)
Baton Rouge, LA ยท Remote
$20 - $22/hr
Office/Clerical Employment Type: Full-Time Work Options: Remote / Work from Home in the US #LI ... As a Document Review Specialist you will be responsible for auditing various documents on behalf of ...
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Office Operations (French Bilingual)
Baton Rouge, LA ยท Remote
$20 - $22/hr
Office/Clerical Employment Type: Full-Time Work Options: Remote / Work from Home in the US #LI ... As a Document Review Specialist you will be responsible for auditing various documents on behalf of ...
New
Survey Rapid Response Spclst
Baton Rouge, LA ยท On-site +1
Overview Provides temporary, onsite and remote clinical, quality, and regulatory support to hospice ... Support survey readiness activities, including mock surveys, documentation review, and staff ...
New
Survey Rapid Response Spclst
Baton Rouge, LA ยท On-site +1
Overview Provides temporary, onsite and remote clinical, quality, and regulatory support to hospice ... Support survey readiness activities, including mock surveys, documentation review, and staff ...
New
Sr. Cloud Engineer
Baton Rouge, LA ยท Remote
This is a contract-to-hire opportunity and is 100% remote. Applicants must be authorized to work ... Employment Type: FULL_TIME
Sr. Cloud Engineer
Baton Rouge, LA ยท Remote
This is a contract-to-hire opportunity and is 100% remote. Applicants must be authorized to work ... Employment Type: FULL_TIME
This is a full-time position based in Baton Rouge, La. Remote candidates will be considered and are ... Ability to quickly review and understand documentation to support testing * SQL experience ...
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This is a full-time position based in Baton Rouge, La. Remote candidates will be considered and are ... Ability to quickly review and understand documentation to support testing * SQL experience ...
We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion ... Remote Education:UNAVAILABLEEmployment Type: FULL_TIME
We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion ... Remote Education:UNAVAILABLEEmployment Type: FULL_TIME
Junior Inside Sales Representative
Baton Rouge, LA ยท Remote
$17/hr
This is a remote position for those that reside in = AL, FL, GA, ID, IA, IN, KS, LA, MI, MS, MO, NE ... - Full Time 40 hours, Benefit eligible 1st of month after 60 days Five Star Solutions values ...
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Junior Inside Sales Representative
Baton Rouge, LA ยท Remote
$17/hr
This is a remote position for those that reside in = AL, FL, GA, ID, IA, IN, KS, LA, MI, MS, MO, NE ... - Full Time 40 hours, Benefit eligible 1st of month after 60 days Five Star Solutions values ...
Junior Inside Sales Representative
Baton Rouge, LA ยท On-site +1
$17/hr
This is a remote position for those that reside in = AL, FL, GA, ID, IA, IN, KS, LA, MI, MS, MO, NE ... - Full Time 40 hours, Benefit eligible 1st of month after 60 days Five Star Solutions values ...
Junior Inside Sales Representative
Baton Rouge, LA ยท On-site +1
$17/hr
This is a remote position for those that reside in = AL, FL, GA, ID, IA, IN, KS, LA, MI, MS, MO, NE ... - Full Time 40 hours, Benefit eligible 1st of month after 60 days Five Star Solutions values ...
Junior Inside Sales Representative
Baton Rouge, LA ยท Remote
$17/hr
This is a remote position for those that reside in = AL, FL, GA, ID, IA, IN, KS, LA, MI, MS, MO, NE ... - Full Time 40 hours, Benefit eligible 1st of month after 60 days Five Star Solutions values ...
Junior Inside Sales Representative
Baton Rouge, LA ยท Remote
$17/hr
This is a remote position for those that reside in = AL, FL, GA, ID, IA, IN, KS, LA, MI, MS, MO, NE ... - Full Time 40 hours, Benefit eligible 1st of month after 60 days Five Star Solutions values ...
Physician - Hepatologist
Baton Rouge, LA ยท On-site +1
... FULL-TIME opportunity for a HEPATOLOGIST to join its busy practice. WHY CHOOSE OCHSNER HEALTH ... Please refer to the to determine whether the position you are interested in is remote or on-site.
Physician - Hepatologist
Baton Rouge, LA ยท On-site +1
... FULL-TIME opportunity for a HEPATOLOGIST to join its busy practice. WHY CHOOSE OCHSNER HEALTH ... Please refer to the to determine whether the position you are interested in is remote or on-site.
Senior Project Engineer - Bridge Design
Baton Rouge, LA ยท On-site +1
$120K - $150K/yr
Civil/Municipal Employment Type: Full Time Location: Baton Rouge, LA Compensation: $120,000 - $150 ... The role has the possibility of being remote for the right candidate. The role will provide quality ...
Senior Project Engineer - Bridge Design
Baton Rouge, LA ยท On-site +1
$120K - $150K/yr
Civil/Municipal Employment Type: Full Time Location: Baton Rouge, LA Compensation: $120,000 - $150 ... The role has the possibility of being remote for the right candidate. The role will provide quality ...
Full Time Remote Utilization Review information
See Baton Rouge, LA salary details
$20.54 - $24.70
2% of jobs
$24.70 - $28.85
9% of jobs
$31.70 is the 25th percentile. Wages below this are outliers.
$28.85 - $33.01
21% of jobs
The median wage is $36.37 / hr.
$33.01 - $37.16
23% of jobs
$37.16 - $41.32
13% of jobs
$44.55 is the 75th percentile. Wages above this are outliers.
$41.32 - $45.47
10% of jobs
$45.47 - $49.63
8% of jobs
$49.63 - $53.78
5% of jobs
$53.78 - $57.94
5% of jobs
$57.94 - $62.09
2% of jobs
$62.09 - $66.25
2% of jobs
$20
$40
$66
How much do full time remote utilization review jobs pay per hour?
What is the difference between Full Time Remote Utilization Review vs Part Time Remote Utilization Review?
| Aspect | Full Time Remote Utilization Review | Part Time Remote Utilization Review |
|---|---|---|
| Work Hours | Typically 40 hours/week | Fewer hours, often less than 20/week |
| Certifications | Required certifications like AAHAM or URAC often needed | Same certifications as full-time, but may vary by employer |
| Work Environment | Remote, full-time employment | Remote, part-time engagement |
| Job Responsibilities | Complete utilization reviews, documentation, compliance | Similar responsibilities but on a reduced schedule |
Full Time Remote Utilization Review involves working 40 hours weekly with comprehensive responsibilities, while Part Time Remote Utilization Review offers flexible, reduced hours with similar duties. Both roles require relevant certifications and are performed remotely, but differ mainly in hours and workload.
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Care Coordinator RN remote work: Baton Rouge or New Orleans
Baton Rouge, LA โข Remote
Full-time
Re-posted 19 days ago
Job description
- Performs care coordination services for assigned recipients who are eligible for home health services (Home Health Visits, PPEC, Personal Care Services and/or Private Duty Nursing Services etc. based on contract requirements).
- Uses discretion to approve/validate UR or forward to 2nd level reviewer. Provides first level utilization review for all inpatient and outpatient services requiring authorization: Prospective Review Urgent/ Non-urgent, Concurrent Review and Retrospective Review.
- Completes prior authorizations as appropriate in a timely manner.
- Conducts an initial survey to recommend appropriate (home health assessment) for the recipient, unless this has already been done during the current fiscal year
- Conducts a home and/or PPEC visit as needed or if contract requirement
- Schedules and convenes initial face-to-face meeting in the recipientโs home and/or PPEC comprised of the recipient (if able) and the parent or legal guardian.
- Assesses, plans, implements, monitors and evaluates the options and services required to meet the recipientโs health care needs.
- Documents recipientโs assessment findings, actions, and outcomes.
- Documents all communication, interventions and follow up tasks in the Care Coordination System within one (1) business day of each intervention and/or encounter.
- Identifies patient care issues and makes recommendations on patient care issues.
- Collaborates with the parent or legal guardian and healthcare team to arrange for identified home care needs.
- Responsible for maintaining regular monthly contact (telephonically or face-to-face) with the recipient and the recipientโs parent or legal guardian.for purpose of updating Plan of Care (POC), resolving issues and identifying additional issues
- As part of the multidisciplinary team, regularly meets with the team and contributes to the development of a comprehensive plan of care based on the needs of the recipient and recipientโs parent or legal guardian.
- Evaluates and modifies recipientโs the plan of care as needed.ย Regularly communicates changes to the recipientโs parent or legal guardian, healthcare team, and other agencies involved in the recipientโs care.
- Monitors assigned caseload eligibility status on a monthly basis, based on their status in MMIS.
- Completes a Staffing Tool (Freedom of Choice) any time a parent or legal guardian expresses the desire to reconsider a recipientโs placement into a Skilled Nursing Facility
- Follow guidelines for additional required calls and visits for Skilled Nursing Facility (SNF) transitions to community settings for six (6) months.
- Functions as a resource to the community.
- Manages daily workload associated with quality review process, including facilitation of case assignments and follows up to ensure that all cases requiring additional assistance or care coordination are completed within timelines required by contract.
- ย Prioritizes and addresses requests and assignments in a professional manner to develop cooperative relationships to ensure that customer confidentiality is assured.
- Provides courteous and prompt service to all internal and external customers at all times.
- Attends staff meetings and continuing education sessions and will assist with learning opportunities as needed.
- Participates in special projects, as needed.
- Assists with the implementation of quality improvement initiatives.
- Performs other duties as assigned.