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Remote Hca Utilization Review Jobs in Baton Rouge, LA

Imh

RN Care Manager - Inpatient

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 ...

Imh

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 ...

All JobsHca Utilization Review JobsRemote Hca Utilization Review JobsRemote Hca Utilization Review Jobs in Baton Rouge, LA

Remote Hca Utilization Review information

See Baton Rouge, LA salary details

$20

$40

$66

How much do remote hca utilization review jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for remote hca utilization review in Baton Rouge, LA is $40.60, according to ZipRecruiter salary data. Most workers in this role earn between $32.07 and $46.63 per hour, depending on experience, location, and employer.

What is the difference between Remote Hca Utilization Review vs Remote Hca Case Manager?

AspectRemote Hca Utilization ReviewRemote Hca Case Manager
CredentialsTypically requires healthcare-related certifications, such as RN or licensed healthcare professionalOften requires RN, social work, or case management certifications
Work EnvironmentPrimarily reviewing medical necessity and insurance coverage remotelyManaging patient cases, coordinating care, and discharge planning remotely
Employer & Industry UsageUsed by health insurance companies, healthcare providers, and utilization review organizationsEmployed by hospitals, insurance companies, and healthcare organizations

Remote Hca Utilization Review focuses on assessing medical necessity and insurance coverage, while Remote Hca Case Managers handle patient care coordination and discharge planning. Both roles require healthcare credentials and are integral to healthcare management, but they differ in daily responsibilities and focus areas.

How do I get into a remote HCA utilization review?

To become a remote HCA utilization review specialist, candidates typically need a healthcare background such as nursing or medical coding, along with knowledge of insurance policies and medical terminology. Relevant certifications like Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) can improve job prospects. Employers often require prior experience in medical review or utilization management and proficiency with electronic health record (EHR) systems, with many roles offering flexible or remote schedules.

Is remote HCA utilization review work from home?

Remote HCA utilization review jobs are often performed from home, allowing reviewers to assess healthcare claims and authorizations remotely. These roles typically require familiarity with healthcare software, strong communication skills, and adherence to confidentiality standards. Many employers offer flexible or fully remote schedules for this position.

What are popular job titles related to Remote Hca Utilization Review jobs in Baton Rouge, LA?

For Remote Hca Utilization Review jobs in Baton Rouge, LA, the most frequently searched job titles are:

What job categories do people searching Remote Hca Utilization Review jobs in Baton Rouge, LA look for?

The top searched job categories for Remote Hca Utilization Review jobs in Baton Rouge, LA are:

What cities near Baton Rouge, LA are hiring for Remote Hca Utilization Review jobs?

Cities near Baton Rouge, LA with the most Remote Hca Utilization Review job openings:

Remote Hca Utilization Review jobs near you
Infographic showing various Remote Hca Utilization Review job openings in Baton Rouge, LA as of August 2026, with employment types broken down into 91% Full Time, and 9% Contract. Highlights an 100% Remote job distribution, with an average salary of $84,449 per year, or $40.6 per hour.

Care Coordinator RN remote work: Baton Rouge or New Orleans

eQHealth Solutions

Baton Rouge, LA • Remote

Full-time

Re-posted 24 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.

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