ZipRecruiter

Log In

1

Utilization Management Nurse Jobs in Baton Rouge, LA

US Tech Solutions

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 ...

xtracit

Clinical Nurse Liaison

Baton Rouge, LA · On-site

$62K - $84K/yr

Education/Experience: LPN or LVN license. RN license preferred. 4+ years of clinical nursing ... Experience working in managed care, utilization management, case management, or quality improvement ...

xtracit

Clinical Nurse Liaison

Baton Rouge, LA

$62K - $84K/yr

Education/Experience: LPN or LVN license. RN license preferred. 4+ years of clinical nursing ... Experience working in managed care, utilization management, case management, or quality improvement ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Baton Rouge, LA · On-site

$45 - $54.75/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track and report ... Managed care or utilization management preferred. Hospital, ambulatory, and community pharmacists ...

Nautilus

Advanced Practice Provider

Baton Rouge, LA · On-site

$150/hr

Provide utilization management support to optimize healthcare resources. * Maintain accurate and ... Current Physician Assistant or Nurse Practitioner license in the state of practice. * Certification ...

UnitedHealth Group

Registered Nurse - RN

Baton Rouge, LA · On-site

$41.35 - $62.03/hr

As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model * Ability to function in ...

UnitedHealth Group

Registered Nurse - RN

Baton Rouge, LA · On-site

$34.46 - $51.69/hr

As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model * Ability to function in ...

UnitedHealth Group

Registered Nurse

Plaquemine, LA · On-site

$41.35 - $62.03/hr

As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...

UnitedHealth Group

Registered Nurse

Plaquemine, LA

$41.35 - $62.03/hr

As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...

UnitedHealth Group

Registered Nurse

Plaquemine, LA

$41.35 - $62.03/hr

As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...

UMR

Registered Nurse - | Rouge, | Group

Baton Rouge, LA · On-site

$34.46 - $51.69/hr

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

next page

Showing results 1-20

All JobsUtilization Management Nurse JobsUtilization Management Nurse Jobs in Baton Rouge, LA

Utilization Management Nurse information

See Baton Rouge, LA salary details

$37.4K

$85.9K

$156.5K

How much do utilization management nurse jobs pay per year?

As of Aug 26, 2026, the average yearly pay for utilization management nurse in Baton Rouge, LA is $85,925.00, according to ZipRecruiter salary data. Most workers in this role earn between $61,900.00 and $100,300.00 per year, depending on experience, location, and employer.

What is a utilization management nurse?

A Utilization Management Nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients. They review medical records and treatment plans to ensure that care meets established guidelines and is cost-effective. Utilization Management Nurses work with healthcare providers, insurance companies, and patients to coordinate care and prevent unnecessary procedures or hospitalizations. Their goal is to support high-quality patient care while managing healthcare costs.

What does a utilization management nurse do?

A utilization management nurse ensures that healthcare services are administered appropriately. Their job responsibilities include working in a hospital, health practice, or other clinical setting reviewing patient clinical records, drafting clinical appeals, and overseeing staff members. The qualifications for a utilization management nurse include a nursing degree and a registered nursing license. Most people in this job also have career experience in case management and utilization review.

What are the key skills and qualifications needed to thrive as a utilization management nurse?

To thrive as a Utilization Management Nurse, you need a registered nursing license, strong clinical judgment, and experience in case management or utilization review. Familiarity with medical management software, InterQual or Milliman guidelines, and insurance authorization processes is typically required. Excellent analytical thinking, communication, and negotiation skills help you coordinate with providers and advocate for patients. These competencies ensure appropriate resource use, compliance with regulations, and optimal patient outcomes.

What are some common challenges a utilization management nurse faces when coordinating care between providers and insurance companies?

A Utilization Management Nurse often navigates the challenge of balancing patient advocacy with insurance guidelines, ensuring that care recommendations meet both clinical standards and payer requirements. Communicating complex medical information to both providers and insurance representatives can be demanding, especially when there are disagreements about coverage or medical necessity. Additionally, staying updated on changing policies and maintaining thorough documentation under tight deadlines are frequent aspects of the role. Strong collaboration skills and attention to detail are essential for success in this position.

What is the difference between Utilization Management Nurse vs Case Manager?

AspectUtilization Management NurseCase Manager
CredentialsRN license, certifications in utilization reviewRN license, case management certification often preferred
Work EnvironmentInsurance companies, healthcare organizations, utilization review departmentsHospitals, community health agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of servicesCoordinating patient care and discharge planning

Utilization Management Nurses primarily focus on reviewing medical necessity and approving healthcare services, while Case Managers coordinate patient care and facilitate discharge planning. Both roles require RN licensure and work within healthcare or insurance settings, but their core responsibilities differ in scope and focus.

More about Utilization Management Nurse jobs

What are the most commonly searched types of Utilization Management Nurse jobs in Baton Rouge, LA?

The most popular types of Utilization Management Nurse jobs in Baton Rouge, LA are:

What are popular job titles related to Utilization Management Nurse jobs in Baton Rouge, LA?

For Utilization Management Nurse jobs in Baton Rouge, LA, the most frequently searched job titles are:

What job categories do people searching Utilization Management Nurse jobs in Baton Rouge, LA look for?

The top searched job categories for Utilization Management Nurse jobs in Baton Rouge, LA are:

What cities near Baton Rouge, LA are hiring for Utilization Management Nurse jobs?

Cities near Baton Rouge, LA with the most Utilization Management Nurse job openings:

Utilization Management Nurse jobs near you
Infographic showing various Utilization Management Nurse job openings in Baton Rouge, LA as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 14% Part Time, and 2% Contract. Highlights an 85% Physical, 2% Hybrid, and 13% Remote job distribution, with an average salary of $85,925 per year, or $41.3 per hour.

Registered Nurse

US Tech Solutions

Baton Rouge, LA • On-site

Other

Re-posted 7 days ago

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.

US Tech Solutions logo

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

Social media

FacebookTwitter

View All US Tech Solutions Jobs

Apply