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 ...
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 ...
Provides medical leadership for Medicare utilization management activities, Organizational Determinations, and medical review activities pertaining to utilization review, quality assurance, medical ...
Provides medical leadership for Medicare utilization management activities, Organizational Determinations, and medical review activities pertaining to utilization review, quality assurance, medical ...
Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements. • ...
Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements. • ...
Become a part of our caring community The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent ...
Become a part of our caring community The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent ...
... management process by determining patient financial and medical eligibility, medical necessity, and ... Responsible for the maintaining the knowledge and skill set related to utilization review, care ...
... management process by determining patient financial and medical eligibility, medical necessity, and ... Responsible for the maintaining the knowledge and skill set related to utilization review, care ...
Clinical Pharmacist - Medical Policy
Baton Rouge, LA · On-site
$93K - $111K/yr
Collaborates with pharmacy reporting and analytics for the purpose of measuring utilization management program effectiveness, identifying medical and pharmacy drug dosing and utilization management ...
Clinical Pharmacist - Medical Policy
Baton Rouge, LA · On-site
$93K - $111K/yr
Collaborates with pharmacy reporting and analytics for the purpose of measuring utilization management program effectiveness, identifying medical and pharmacy drug dosing and utilization management ...
RN-MDS Clinical Care Coordinator
Baton Rouge, LA · On-site
$29.25 - $35.25/hr
Monitor and track patient progress and outcomes to support care planning and utilization management. * Collaborate with healthcare providers to develop effective discharge plans. * Maintain up-to ...
RN-MDS Clinical Care Coordinator
Baton Rouge, LA · On-site
$29.25 - $35.25/hr
Monitor and track patient progress and outcomes to support care planning and utilization management. * Collaborate with healthcare providers to develop effective discharge plans. * Maintain up-to ...
As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical ...
As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical ...
Field Medical Director, Vascular Surgeon
Baton Rouge, LA · On-site
$130 - $140/hr
As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...
Field Medical Director, Vascular Surgeon
Baton Rouge, LA · On-site
$130 - $140/hr
As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...
Clinical Pharmacist - Medical Policy
Baton Rouge, LA · On-site
$93K - $111K/yr
Collaborates with pharmacy reporting and analytics for the purpose of measuring utilization management program effectiveness, identifying medical and pharmacy drug dosing and utilization management ...
Clinical Pharmacist - Medical Policy
Baton Rouge, LA · On-site
$93K - $111K/yr
Collaborates with pharmacy reporting and analytics for the purpose of measuring utilization management program effectiveness, identifying medical and pharmacy drug dosing and utilization management ...
Clinical Pharmacist - Medical Policy
Baton Rouge, LA · On-site
$113K - $135K/yr
Collaborates with pharmacy reporting and analytics for the purpose of measuring utilization management program effectiveness, identifying medical and pharmacy drug dosing and utilization management ...
Clinical Pharmacist - Medical Policy
Baton Rouge, LA · On-site
$113K - $135K/yr
Collaborates with pharmacy reporting and analytics for the purpose of measuring utilization management program effectiveness, identifying medical and pharmacy drug dosing and utilization management ...
Clinical Pharmacist - Medical Policy
Baton Rouge, LA · On-site
$113K - $135K/yr
Collaborates with pharmacy reporting and analytics for the purpose of measuring utilization management program effectiveness, identifying medical and pharmacy drug dosing and utilization management ...
Clinical Pharmacist - Medical Policy
Baton Rouge, LA · On-site
$113K - $135K/yr
Collaborates with pharmacy reporting and analytics for the purpose of measuring utilization management program effectiveness, identifying medical and pharmacy drug dosing and utilization management ...
Responsible for utilization of clinical and financial resources by: ensuring appropriate clinical ... CRITERIA E: Cost Management - Employee demonstrates effective cost management practices.
Responsible for utilization of clinical and financial resources by: ensuring appropriate clinical ... CRITERIA E: Cost Management - Employee demonstrates effective cost management practices.
Responsible for utilization of clinical and financial resources by: ensuring appropriate clinical ... CRITERIA E: Cost Management - Employee demonstrates effective cost management practices.
Responsible for utilization of clinical and financial resources by: ensuring appropriate clinical ... CRITERIA E: Cost Management - Employee demonstrates effective cost management practices.
Responsible for utilization of clinical and financial resources by: ensuring appropriate clinical ... CRITERIA E: Cost Management - Employee demonstrates effective cost management practices.
Responsible for utilization of clinical and financial resources by: ensuring appropriate clinical ... CRITERIA E: Cost Management - Employee demonstrates effective cost management practices.
Program Manager 1--A--LDH (Innovative Care Initiative Manager)
Baton Rouge, LA · On-site
$5.0K - $9.8K/mo
Experience with payer-provider contracting, quality improvement, utilization management, or healthcare transformation initiatives. Location: Office of the Secretary / Rural Health Transformation and ...
Program Manager 1--A--LDH (Innovative Care Initiative Manager)
Baton Rouge, LA · On-site
$5.0K - $9.8K/mo
Experience with payer-provider contracting, quality improvement, utilization management, or healthcare transformation initiatives. Location: Office of the Secretary / Rural Health Transformation and ...
Program Manager 1--A--LDH (Innovative Care Initiative Manager)
Baton Rouge, LA · On-site
$5.0K - $9.8K/mo
Experience with payer-provider contracting, quality improvement, utilization management, or healthcare transformation initiatives. Location: Office of the Secretary / Rural Health Transformation and ...
Program Manager 1--A--LDH (Innovative Care Initiative Manager)
Baton Rouge, LA · On-site
$5.0K - $9.8K/mo
Experience with payer-provider contracting, quality improvement, utilization management, or healthcare transformation initiatives. Location: Office of the Secretary / Rural Health Transformation and ...
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 ...
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 ...
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:
Quick apply
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:
(Orthopedic Surgery) Field Medical Director, MSK Surgery
Baton Rouge, LA · On-site
$135 - $150/hr
As a Field Medical Director, MSK Surgery you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...
(Orthopedic Surgery) Field Medical Director, MSK Surgery
Baton Rouge, LA · On-site
$135 - $150/hr
As a Field Medical Director, MSK Surgery you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...
Manager Utilization Management information
See Walker, LA salary details
$35.8K - $46.5K
9% of jobs
$54.4K is the 25th percentile. Wages below this are outliers.
$46.5K - $57.2K
22% of jobs
$57.2K - $67.9K
11% of jobs
The median wage is $74.5K / yr.
$67.9K - $78.6K
14% of jobs
$78.6K - $89.3K
12% of jobs
$96K is the 75th percentile. Wages above this are outliers.
$89.3K - $100K
13% of jobs
$100K - $110.7K
13% of jobs
$110.7K - $121.5K
5% of jobs
$121.5K - $132.2K
2% of jobs
$132.2K - $142.9K
0% of jobs
$142.9K - $153.6K
0% of jobs
$35.8K
$83.5K
$153.6K
How much do manager utilization management jobs pay per year?
As of Aug 15, 2026, the average yearly pay for manager utilization management in Walker, LA is $83,452.00, according to ZipRecruiter salary data. Most workers in this role earn between $54,600.00 and $100,400.00 per year, depending on experience, location, and employer.
What are the key skills and qualifications needed to thrive as a manager utilization management?
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?
| Aspect | Manager Utilization Management | Utilization Review Nurse |
|---|---|---|
| Credentials | RN, often with management or utilization review certifications | RN, with certifications in utilization review or case management |
| Work Environment | Supervises teams, manages policies, oversees utilization review processes | Performs patient chart reviews, assesses medical necessity, collaborates with providers |
| Employer & Industry | Hospitals, insurance companies, healthcare organizations | Hospitals, insurance companies, healthcare organizations |
| Search & Comparison Intent | Yes | Yes |
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 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 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 cities near Walker, LA are hiring for Manager Utilization Management jobs?
Cities near Walker, LA with the most Manager Utilization Management job openings:
Job description
Work At Home, LA
Contract
Position Summary:
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 direct relationships with providers and medical directors through review of member clinical information, applying criteria, and completing authorization determinations in accordance with company policies and procedures, Document patient care activity and communication with the, provider and medical director. Participate in on call rotation as indicated by staffing and business needs.
Duties:
-
Registered Nurse with current license in LA state of employment. Additional licensure may be required in multi-state service areas.
-
Minimum 3 years nursing experience with a minimum of 1 year in utilization management/ prior authorization review experience.
Experience :
Utilization Management. Prior Authorization Review experience
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com/) .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
About US Tech Solutions
Sourced by ZipRecruiter
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.
Industry
It services
Company size
1,001 - 5,000 Employees
Headquarters location
Jersey City, NJ, US
Year founded
2000