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.
Compliance Manager
Baton Rouge, LA · 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 · 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.
Basic utilization of computer to interface with proprietary remote equipment operating programing ... For further information, please review the Know Your Rights notice from the Department of Labor.
Basic utilization of computer to interface with proprietary remote equipment operating programing ... For further information, please review the Know Your Rights notice from the Department of Labor.
Practice Performance Advisor
Baton Rouge, LA · On-site +1
Those fully remote associates residing in states where service is required by contract, law, or ... Interprets utilization trends, optimizing performance based on state driven quality improvement ...
New
Practice Performance Advisor
Baton Rouge, LA · On-site +1
Those fully remote associates residing in states where service is required by contract, law, or ... Interprets utilization trends, optimizing performance based on state driven quality improvement ...
New
Practice Performance Advisor
Baton Rouge, LA · On-site +1
Those fully remote associates residing in states where service is required by contract, law, or ... Interprets utilization trends, optimizing performance based on state driven quality improvement ...
New
Practice Performance Advisor
Baton Rouge, LA · On-site +1
Those fully remote associates residing in states where service is required by contract, law, or ... Interprets utilization trends, optimizing performance based on state driven quality improvement ...
New
Call Center Representative (Healthcare) - Baton Rouge, LA - Remote
Baton Rouge, LA · 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 · 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 · 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 · 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 · 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 · 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 · 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 · 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 · 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 · 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 · 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 · 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 ...
Manager - Resource Management (Tax)
Baton Rouge, LA · On-site +1
$106K - $139K/yr
We are also open to the role being remote from TX or surrounding states. What it Means to Work for ... Monitor resources and their utilization, serving as the primary point of contact for local ...
Manager - Resource Management (Tax)
Baton Rouge, LA · On-site +1
$106K - $139K/yr
We are also open to the role being remote from TX or surrounding states. What it Means to Work for ... Monitor resources and their utilization, serving as the primary point of contact for local ...
Manager - Resource Management (Tax)
Baton Rouge, LA · On-site +1
$106K - $139K/yr
We are also open to the role being remote from TX or surrounding states. What it Means to Work for ... Monitor resources and their utilization, serving as the primary point of contact for local ...
Manager - Resource Management (Tax)
Baton Rouge, LA · On-site +1
$106K - $139K/yr
We are also open to the role being remote from TX or surrounding states. What it Means to Work for ... Monitor resources and their utilization, serving as the primary point of contact for local ...
... utilization of Goulds Pumps quoting software. While primarily focused on supporting our ... Remote candidates may also be considered. Essential Responsibilities May include: * Review customer ...
... utilization of Goulds Pumps quoting software. While primarily focused on supporting our ... Remote candidates may also be considered. Essential Responsibilities May include: * Review customer ...
Office Operations (French Bilingual)
Baton Rouge, LA · 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 ...
Office Operations (French Bilingual)
Baton Rouge, LA · 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 ...
Office Operations (French Bilingual)
Baton Rouge, LA · 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 ...
Office Operations (French Bilingual)
Baton Rouge, LA · 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 ...
Utility Sales Support
LA · Remote
$17.75 - $23.25/hr
While this is a remote position, candidates must be located in the United States. You will be ... Must have knowledge and skill in utilization of computer databases; empower experience preferred
Utility Sales Support
LA · Remote
$17.75 - $23.25/hr
While this is a remote position, candidates must be located in the United States. You will be ... Must have knowledge and skill in utilization of computer databases; empower experience preferred
Instructional Operations Coordinator
Baton Rouge, LA · On-site +1
$40K - $45K/yr
Instructional Operations Employment Type: Full Time Location: Remote - USA Reporting To ... Clean up and organize evaluation data and prepare it for review by team leaders. * Enter paper and ...
Instructional Operations Coordinator
Baton Rouge, LA · On-site +1
$40K - $45K/yr
Instructional Operations Employment Type: Full Time Location: Remote - USA Reporting To ... Clean up and organize evaluation data and prepare it for review by team leaders. * Enter paper and ...
Network Contractor PNM
Baton Rouge, LA · On-site +1
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet ... Employment Type: FULL_TIME
New
Network Contractor PNM
Baton Rouge, LA · On-site +1
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet ... Employment Type: FULL_TIME
New
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.
What are the most commonly searched types of Remote Utilization Review jobs in Baton Rouge, LA?
The most popular types of Remote Utilization Review jobs in Baton Rouge, LA are:
What are popular job titles related to Full Time Remote Utilization Review jobs in Baton Rouge, LA?
For Full Time Remote Utilization Review jobs in Baton Rouge, LA, the most frequently searched job titles are:
- Remote Utilization Review Nurse
- Behavioral Health Utilization Review
- Remote Telephonic Nurse
- Remote Utilization Review Rn
- Utilization Review Physician
- Full Time Physician Advisor Utilization Review
- Weekend Physician Advisor Utilization Review
- Temporary Utilization Review Nurse
- Evening Optum Health Utilization Review
- Freelance Utilization Review Nurse
What job categories do people searching Full Time Remote Utilization Review jobs in Baton Rouge, LA look for?
The top searched job categories for Full Time Remote Utilization Review jobs in Baton Rouge, LA are:
- Utilization Review
- Lpn Utilization Review
- Part Time Utilization Review
- Cigna Utilization Review Remote
- Remote Chiropractic Utilization Review
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- Temporary Aetna Utilization Review Nurse
- Free Utilization Review Training
- Remote Occupational Therapy Utilization Review
- Remote Optum Utilization Review
Care Coordinator RN remote work: Baton Rouge or New Orleans
Baton Rouge, LA • Remote
Full-time
Re-posted 11 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 recipient’s 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 recipient’s health care needs.
- Documents recipient’s 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 recipient’s 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 recipient’s parent or legal guardian.
- Evaluates and modifies recipient’s the plan of care as needed. Regularly communicates changes to the recipient’s parent or legal guardian, healthcare team, and other agencies involved in the recipient’s 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 recipient’s 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.
- 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.