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Manager Utilization Management Jobs in Baton Rouge, LA

Health organization

UR Director LPN

Baton Rouge, LA · On-site

This leadership position offers the opportunity to oversee utilization management operations, improve reimbursement outcomes, ensure regulatory compliance, and collaborate with an interdisciplinary ...

New

US Tech Solutions

Registered Nurse

Baton Rouge, LA · On-site

As a Prior Authorization Nurse, you work outside the walls of a hospital setting in a specialty area of the nursing field providing utilization management prior authorization reviews. Build strong ...

xtracit

Clinical Nurse Liaison

Baton Rouge, LA · On-site

$62K - $84K/yr

Experience working in managed care, utilization management, case management, or quality improvement preferred. Qualifications Additional Information All your information will be kept confidential ...

xtracit

Clinical Nurse Liaison

Baton Rouge, LA · On-site

$62K - $84K/yr

Experience working in managed care, utilization management, case management, or quality improvement preferred. Additional Information All your information will be kept confidential according to EEO ...

Nautilus

Advanced Practice Provider

Baton Rouge, LA · On-site

$150/hr

Provide utilization management support to optimize healthcare resources. * Maintain accurate and current medical records. * Adhere to workers' compensation legislation and regulations. Qualifications:

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All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Baton Rouge, LA

Manager Utilization Management information

See Baton Rouge, LA salary details

$37.4K

$87.4K

$160.8K

How much do manager utilization management jobs pay per year?

As of Jul 26, 2026, the average yearly pay for manager utilization management in Baton Rouge, LA is $87,392.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,100.00 and $105,100.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Manager Utilization Management, and why are they important?

To thrive as a Manager Utilization Management, you need a thorough understanding of healthcare regulations, utilization review processes, and case management, often supported by a clinical degree (such as RN) and relevant experience. Familiarity with utilization management software, claims processing systems, and potentially certifications like CCM (Certified Case Manager) or ACM (Accredited Case Manager) is important. Strong leadership, analytical thinking, and effective communication help you guide teams and collaborate with providers and payers. These skills ensure efficient resource use, compliance, and quality patient care within managed care organizations.

What is the difference between Manager Utilization Management vs Utilization Review Nurse?

AspectManager Utilization ManagementUtilization Review Nurse
CredentialsRN, often with management or utilization review certificationsRN, with certifications in utilization review or case management
Work EnvironmentSupervises teams, manages policies, oversees utilization review processesPerforms patient chart reviews, assesses medical necessity, collaborates with providers
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare organizations
Search & Comparison IntentYesYes

While both roles focus on utilization review, the Manager Utilization Management oversees teams and policies, ensuring efficient resource use, whereas the Utilization Review Nurse conducts patient-specific reviews to determine medical necessity. The manager role involves leadership and strategic planning, while the nurse role is more clinical and review-focused.

What are some common challenges faced by a Manager in Utilization Management, and how can they effectively address them?

Managers in Utilization Management often encounter challenges such as balancing quality patient care with cost containment, navigating evolving healthcare regulations, and managing diverse teams. To effectively address these issues, successful managers develop strong communication skills, stay updated on industry standards, and foster collaboration between clinical and administrative staff. Implementing robust training programs and utilizing data-driven decision-making can also help ensure compliance and improve overall team performance.

What does a Manager of Utilization Management do?

A Manager of Utilization Management oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They lead a team that reviews medical claims and care plans to ensure compliance with clinical guidelines and regulatory requirements. Their role often involves collaborating with physicians, nurses, insurance companies, and other stakeholders to optimize patient outcomes while managing healthcare costs. Additionally, they are responsible for implementing policies, training staff, and ensuring that utilization management activities align with organizational goals.
What are the most commonly searched types of Utilization Management jobs in Baton Rouge, LA? The most popular types of Utilization Management jobs in Baton Rouge, LA are:
What are popular job titles related to Manager Utilization Management jobs in Baton Rouge, LA? For Manager Utilization Management jobs in Baton Rouge, LA, the most frequently searched job titles are:
What job categories do people searching Manager Utilization Management jobs in Baton Rouge, LA look for? The top searched job categories for Manager Utilization Management jobs in Baton Rouge, LA are:
What cities near Baton Rouge, LA are hiring for Manager Utilization Management jobs? Cities near Baton Rouge, LA with the most Manager Utilization Management job openings:
Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Baton Rouge, LA as of July 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, 1% Temporary, and 2% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $87,392 per year, or $42 per hour.

UR Director LPN

Health organization

Baton Rouge, LA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

Job description

A growing behavioral health organization is conducting a confidential search for an experienced Director of Utilization Review. This leadership position offers the opportunity to oversee utilization management operations, improve reimbursement outcomes, ensure regulatory compliance, and collaborate with an interdisciplinary team dedicated to delivering exceptional patient care.

Position Summary

The Director of Utilization Review is responsible for leading all aspects of the Utilization Review program, including medical necessity reviews, payer authorizations, denial management, regulatory compliance, and staff supervision. This position works closely with physicians, nursing leadership, case management, and clinical teams to promote quality outcomes and efficient resource utilization.

Responsibilities

·         Lead the daily operations of the Utilization Review department.

·         Ensure timely submission of initial and concurrent insurance authorizations.

·         Oversee medical necessity reviews using payer-specific guidelines and industry-recognized criteria.

·         Manage peer-to-peer reviews, appeals, and denial prevention strategies.

·         Monitor key performance indicators, including authorization turnaround times, denial rates, and length of stay.

·         Ensure compliance with CMS, Joint Commission, HIPAA, and applicable state regulations.

·         Develop and implement Utilization Review policies, procedures, and best practices.

·         Supervise, mentor, and evaluate Utilization Review staff.

·         Collaborate with interdisciplinary teams to support quality patient care and financial performance.

·         Participate in Quality Assessment and Performance Improvement (QAPI) initiatives.

Qualifications

·         Minimum of LPN credentials required. A degree from an accredited college or university with emphasis in a related behavioral healthcare field or in nursing preferred.

·         Minimum of three (3) years of Utilization Review, Case Management, or Utilization Management experience in an acute care or behavioral health setting.

·         Previous leadership or supervisory experience preferred.

·         Knowledge of Medicare, Medicaid, Managed Care, and Commercial insurance authorization processes.

·         Strong understanding of behavioral health documentation standards and reimbursement guidelines.

·         Excellent communication, leadership, organizational, and analytical skills.

Compensation & Benefits

·         Competitive salary based on experience

·         Comprehensive medical, dental, vision, and life insurance

·         Paid Time Off (PTO)

·         Retirement savings plan

·         Professional development opportunities

How to Apply

Qualified candidates are encouraged to submit a current résumé and cover letter for confidential consideration. Only candidates selected for an interview will be contacted.

Equal Employment Opportunity

Seaside Health System is committed to the principle of Equal Employment Opportunity for all employees and applicants. It is our policy to ensure that both current and prospective employees are afforded equal employment opportunity without consideration of race, religious creed, color, national origin, nationality, ancestry, age, sex, marital status, sexual orientation, or disability in accordance with local, state and federal laws.

Americans with Disabilities Act

Applicants as well as employees who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation. The organization shall determine reasonable accommodation on a case-by-case basis in accordance with applicable law.