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Senior Rn Utilization Review Nurse Jobs in Baton Rouge, LA

RN Care Manager

New Roads, LA · Remote

$41.20 - $62.17/hr

The RN Hospital Care Manager I delivers comprehensive care management services to designated ... Demonstrated experience in case management, utilization review, value-based care, and/or discharge ...

RN Care Manager - PRN

New Roads, LA · Remote

$41.20 - $62.17/hr

The RN Hospital Care Manager I delivers comprehensive care management services to designated ... Demonstrated experience in case management, utilization review, value-based care, and/or discharge ...

HEDIS Nurse

Baton Rouge, LA · On-site

$29 - $38.50/hr

HEDIS RN/LPN Location: Baton Rouge, LA Daily Responsibilities: * Performs provider/practitioner medical record reviews, abstraction and data entry for HEDIS and HEDIS-like measures * Reviews assigned ...

Registered Nurse - RN

Gonzales, LA · On-site

$41.35 - $62.03/hr

Registered Nurse In Home Health Explore opportunities with Feliciana Home Health South, a part of ... Adheres to and participates in the agency's utilization management model * Ability to function in ...

Registered Nurse - RN

Gonzales, LA · On-site

$41.35 - $62.03/hr

Registered Nurse In Home Health Explore opportunities with Feliciana Home Health South, a part of ... Adheres to and participates in the agency's utilization management model * Ability to function in ...

Showing results 21-40

Senior Rn Utilization Review Nurse information

See Baton Rouge, LA salary details

$20

$40

$66

How much do senior rn utilization review nurse jobs pay per hour?

As of Aug 13, 2026, the average hourly pay for senior rn utilization review nurse 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 Senior Rn Utilization Review Nurse vs Rn Case Manager?

AspectSenior Rn Utilization Review NurseRn Case Manager
CertificationsRN license, possibly UR or case management certificationRN license, often case management certification
Work EnvironmentHospitals, insurance companies, healthcare organizationsHospitals, community health, insurance providers
Primary FocusReviewing medical necessity and utilization of servicesCoordinating patient care and discharge planning
Common UsageUsed in insurance and healthcare review settingsUsed in patient care coordination and discharge planning

The Senior Rn Utilization Review Nurse primarily focuses on evaluating the necessity and appropriateness of healthcare services, often working within insurance companies or healthcare organizations. In contrast, Rn Case Managers concentrate on coordinating patient care, discharge planning, and ensuring smooth healthcare delivery. Both roles require RN licensure and relevant certifications, but their daily responsibilities and work environments differ slightly.

What does a Senior RN Utilization Review Nurse do?

A Senior RN Utilization Review Nurse is a registered nurse who evaluates the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, apply clinical guidelines, and collaborate with healthcare providers to ensure that treatments are cost-effective and meet established standards of care. Additionally, they often mentor junior staff, participate in policy development, and help optimize resource utilization within healthcare organizations. Their work supports quality patient care while managing healthcare costs.

What are some typical challenges faced by a Senior RN Utilization Review Nurse when coordinating with multidisciplinary teams?

Senior RN Utilization Review Nurses often collaborate with physicians, case managers, and insurance representatives to ensure patients receive appropriate, cost-effective care. A common challenge is balancing clinical guidelines with payer requirements, which can sometimes lead to differing opinions on the necessity of certain treatments or services. Effective communication, strong negotiation skills, and up-to-date knowledge of regulatory standards are essential to navigate these situations successfully. Being proactive and maintaining strong professional relationships helps facilitate smoother approvals and promotes patient-centered care.

What are the key skills and qualifications needed to thrive as a Senior RN Utilization Review Nurse, and why are they important?

To thrive as a Senior RN Utilization Review Nurse, you need a strong clinical nursing background, active RN licensure, and in-depth knowledge of medical necessity criteria and healthcare regulations. Familiarity with utilization review software, electronic health records (EHRs), and certifications like CCM (Certified Case Manager) or URAC are highly beneficial. Exceptional critical thinking, attention to detail, and effective communication skills distinguish top performers in this role. These skills ensure accurate case evaluations, compliance with regulations, and optimized patient care while controlling healthcare costs.
What are the most commonly searched types of Rn Utilization Review Nurse jobs in Baton Rouge, LA? The most popular types of Rn Utilization Review Nurse jobs in Baton Rouge, LA are:
What job categories do people searching Senior Rn Utilization Review Nurse jobs in Baton Rouge, LA look for? The top searched job categories for Senior Rn Utilization Review Nurse jobs in Baton Rouge, LA are:
What cities near Baton Rouge, LA are hiring for Senior Rn Utilization Review Nurse jobs? Cities near Baton Rouge, LA with the most Senior Rn Utilization Review Nurse job openings:
Infographic showing various Senior Rn Utilization Review Nurse job openings in Baton Rouge, LA as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $84,449 per year, or $40.6 per hour.

RN Care Manager

Imh

New Roads, LA • Remote

$41.20 - $62.17/hr

Part-time

Posted 20 days ago


Job description

Job Description:

The RN Hospital Care Manager I delivers comprehensive care management services to designated patients, leveraging clinical expertise for screenings, assessments, and evaluations. This role involves developing and implementing patient-centered care plans with shared goals and tailored interventions. The Care Manager collaborates seamlessly with patients, families/caregivers, healthcare providers, payers, community-based providers, and other stakeholders to ensure efficient, effective, and patient-focused care management. This position spans various departments, including both Inpatient and Outpatient areas.

Shift Details:

Saturday and Sunday - 0800-1630

Essential Functions

  • Assessment: Identifies patients using screening criteria and conduct comprehensive evaluations.
  • Care Planning: Develops, adjusts, and coordinates care plans to address medical and social needs.
  • Patient Support: Guides self-management using motivational interviewing and coaching.
  • Education & Advocacy: Provides education to healthcare teams and patients, advocate for patient rights, and support self-care.
  • Collaboration: Works with multidisciplinary teams to ensure timely, high-quality care.
  • Process Improvement: Leads initiatives to enhance care transitions and policy adherence.
  • Advanced Care Planning: Provides Goals of Care education for informed decision-making.
  • Data Analysis & Compliance: Tracks key metrics, analyze trends, and ensure regulatory compliance.

Skills

  • Assessment
  • Care Planning
  • Motivational Interviewing
  • Critical Thinking
  • Time Management
  • Customer Service
  • Patient Education
  • Communication
  • Prioritization

Minimum Qualifications

  • Current Registered Nurse (RN) license in state of practice.
  • Bachelor of Science in Nursing (BSN) from an accredited institution (degree verification required). RNs hired or promoted into this role must obtain their BSN within four (4) years of their hire or promotion date. If there is an existing education agreement, that agreement will take precedence.
  • Demonstrated clinical nursing experience in an inpatient hospital setting, and familiarity with hospital patient-related terminology and processes.
  • Demonstrated understanding of disease management including treatment, length of stay, identifying barriers to delivery of care and any variation.

Preferred Qualification

  • Bachelor of Science in Nursing (BSN) from an accredited institution.
  • Case Management Certification
  • Demonstrated experience in case management, utilization review, value-based care, and/or discharge planning.
  • Basic computer skills, including proficiency in word processing and spreadsheet software. Intermediate knowledge of word processing and Excel software.

Physical Requirements

  • Ongoing need for employee to see and read information, labels, documents, monitors, identify equipment and supplies, and be able to assess customer needs.
  • Frequent interactions with providers, colleagues, customers, patients/clients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.
  • Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc.
  • Mental stamina and flexibility- ability to handle high stress situations, make quick decisions, and manage multiple tasks simultaneously.
  • For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing, and reading signs, traffic signals, and other vehicles.

Location:

St. Marys Regional Hospital

Work City:

Grand Junction

Work State:

Colorado

Scheduled Weekly Hours:

16

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$41.20 - $62.17

We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.


Learn more about our comprehensive benefits package here.


By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.


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