Manager Utilization Management Jobs in Baton Rouge, LA

Explore opportunities with Baton Rouge General Home Health, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together.

As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies. You will also coordinate total plan of care with other health care professionals involved in care and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources.

Primary Responsibilities:

• Clinical Competence
  • Initiates, develops, implements, and revises the plan of care in collaboration with the physician and other health care professionals
  • Supervises care provided by home health aides and licensed practical/vocational nurses, provides instruction, and assigns tasks according to State and federal regulations
  • Provides required supervisory visits
• Documentation and Care Delivery
  • Provides high-quality clinical services within the scope of practice and infection control standards, in accordance with the plan of care, and in coordination with other health care team members
  • Completes comprehensive assessments (OASIS) including medication reconciliation accurately and timely
  • Documents patient visits per policy and payer requirements, and syncs timely per LHC policy
• Quality
  • Makes initial and/or comprehensive nursing evaluation visits, ensures patients meet home health eligibility and medical necessity guidelines, determines primary focus of care, develops the plan of care within State guidelines with the physician, and submits accurate documentation
  • Communicates relevant information timely and effectively with appropriate agency staff, including patient care issues, visit assignments, schedule changes, orders, OASIS data sets, coding requests, and coordination with other clinicians
  • Communicates timely and effectively with physicians, patients, and family members to ensure quality care and service excellence
• Teamwork
  • Takes direction from Clinical Director and Executive Director professionally and completes assigned tasks timely, including required learning
  • Assists in the orientation of new agency personnel and serves as a preceptor to other staff and students
  • Actively participates in survey/survey readiness activities and performance improvement plans, works to reduce unnecessary patient hospitalizations, improve patient safety, and implements processes and best practices to ensure positive patient outcomes
  • Participates in on-call and weekend rotation as needed to meet patient needs
  • Adheres to and participates in the agency's utilization management model
• Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Current and unrestricted RN licensure in state of practice
• Current Driver's License, vehicle insurance, and access to a dependable vehicle or public transportation LA: * 1+ years of clinical experience as a Registered Nurse * 1+ years of clinical experience as a Registered Nurse may be waived for a Registered Nurse with recent clinical experience as an LPN * RN licensure must have no restrictions

Preferred Qualifications:

• Current CPR Certification or ability to complete within 90 days of hire
• 1+ years of Home Health experience
• Ability to work independently
• Solid communication, writing, and organizational skills

Pay Range $64,100 - $141,500 annual total cash target pay $36.98 - $81.63 per visit point $30.82 - $68.03 hourly rate