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 · Remote
$60K - $70K/yr
Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ... li-remote Based on the nature of this role, you will need to complete several state background ...
Clinical Admissions Therapist (Louisiana)
Baton Rouge, LA · Remote
$60K - $70K/yr
Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ... li-remote Based on the nature of this role, you will need to complete several state background ...
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.
... remote work location will be explored. PRIMARY PURPOSE OF THE ROLE :To process low level general ... utilization review. * Maintains professional client relationships. * Performs other duties as ...
... remote work location will be explored. PRIMARY PURPOSE OF THE ROLE :To process low level general ... utilization review. * Maintains professional client relationships. * Performs other duties as ...
... remote work location will be explored. PRIMARY PURPOSE OF THE ROLE :To process low level general ... utilization review. * Maintains professional client relationships. * Performs other duties as ...
... remote work location will be explored. PRIMARY PURPOSE OF THE ROLE :To process low level general ... utilization review. * Maintains professional client relationships. * Performs other duties as ...
RN Care Manager
New Roads, LA · Remote
$41.20 - $62.17/hr
Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...
RN Care Manager
New Roads, LA · Remote
$41.20 - $62.17/hr
Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...
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.
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 ...
Overnight 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 overnight remote utilization review jobs pay per hour?
What is the difference between Overnight Remote Utilization Review vs Daytime Remote Utilization Review?
| Aspect | Overnight Remote Utilization Review | Daytime Remote Utilization Review |
|---|---|---|
| Work Hours | Typically overnight shifts, often 10 PM to 6 AM | Standard daytime hours, usually 8 AM to 4 PM |
| Certifications | Same as utilization review roles, e.g., RN, CPC, or other healthcare credentials | Same as overnight roles, requiring similar certifications |
| Work Environment | Remote, focused on reviewing cases during night hours | Remote, reviewing cases during daytime hours |
| Employer & Industry | Healthcare insurance companies, third-party administrators | Same as overnight, within healthcare and insurance sectors |
Overnight Remote Utilization Review involves reviewing cases during night hours, providing flexibility for healthcare providers and insurers. Daytime Remote Utilization Review occurs during regular business hours. Both roles require similar credentials and work environments but differ mainly in shift timing, catering to different operational needs.
What are the main challenges faced by overnight remote utilization review professionals, and how can they be addressed?
What are the key skills and qualifications needed to thrive as an overnight remote utilization review?
What is an overnight remote utilization review?
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Care Coordinator RN remote work: Baton Rouge or New Orleans
Baton Rouge, LA • Remote
Full-time
Re-posted 27 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.