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Utilization Management Jobs in Baton Rouge, LA (NOW HIRING)

Health organization

UR Director LPN

Baton Rouge, LA

This leadership position offers the opportunity to oversee utilization management operations, improve reimbursement outcomes, ensure regulatory compliance, and collaborate with an interdisciplinary ...

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

$62K - $84K/yr

Experience working in managed care, utilization management, case management, or quality improvement preferred. Additional Information All your information will be kept confidential according to EEO ...

xtracit

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 ...

Nautilus

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:

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Utilization Management information

See Baton Rouge, LA salary details

$30.6K

$70.2K

$127.9K

How much do utilization management jobs pay per year?

As of Jul 28, 2026, the average yearly pay for utilization management in Baton Rouge, LA is $70,203.00, according to ZipRecruiter salary data. Most workers in this role earn between $50,600.00 and $82,000.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Utilization Management position, and why are they important?

To thrive in Utilization Management, you need a strong understanding of healthcare procedures, insurance guidelines, and case review processes, usually backed by a clinical background such as RN, LPN, or allied health certification. Familiarity with medical management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is often required. Excellent analytical thinking, attention to detail, and effective communication skills greatly enhance performance in this role. These competencies enable accurate assessment of medical necessity, ensure regulatory compliance, and support efficient, collaborative workflows between providers, insurers, and patients.

What is a Utilization Management job?

A Utilization Management (UM) job involves evaluating medical services to ensure they are necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this field review patient care plans, authorize treatments, and collaborate with healthcare providers to optimize resource use. They work for insurance companies, hospitals, or healthcare organizations to balance quality care with cost control. Strong analytical skills and knowledge of medical policies are essential in this role.

What are the typical daily responsibilities of a Utilization Management professional?

As a Utilization Management professional, your day-to-day duties typically include reviewing patient admissions, authorizing ongoing treatment or procedures, assessing medical necessity, and ensuring services comply with insurance policies and industry guidelines. You will frequently collaborate with physicians, nurses, and insurance representatives to facilitate timely and appropriate care decisions while managing cost and quality. Documentation and communication play key roles as you help bridge the gap between clinical teams and payers. This role is often fast-paced, requires decisive action, and provides opportunities to have a direct impact on patient outcomes and organizational efficiency.

What are the most commonly searched types of Utilization Management jobs in Baton Rouge, LA? The most popular types of Utilization Management jobs in Baton Rouge, LA are:
What are popular job titles related to Utilization Management jobs in Baton Rouge, LA? For Utilization Management jobs in Baton Rouge, LA, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Baton Rouge, LA look for? The top searched job categories for Utilization Management jobs in Baton Rouge, LA are:
What cities near Baton Rouge, LA are hiring for Utilization Management jobs? Cities near Baton Rouge, LA with the most Utilization Management job openings:
Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Baton Rouge, LA as of July 2026, with employment types broken down into 89% Full Time, and 11% Contract. Highlights an 100% In-person job distribution, with an average salary of $70,203 per year, or $33.8 per hour.

UR Director LPN

Health organization

Baton Rouge, LA

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 3 days ago

Job description

A growing behavioral health organization is conducting a confidential search for an experienced Director of Utilization Review. This leadership position offers the opportunity to oversee utilization management operations, improve reimbursement outcomes, ensure regulatory compliance, and collaborate with an interdisciplinary team dedicated to delivering exceptional patient care.

Position Summary

The Director of Utilization Review is responsible for leading all aspects of the Utilization Review program, including medical necessity reviews, payer authorizations, denial management, regulatory compliance, and staff supervision. This position works closely with physicians, nursing leadership, case management, and clinical teams to promote quality outcomes and efficient resource utilization.

Responsibilities

·         Lead the daily operations of the Utilization Review department.

·         Ensure timely submission of initial and concurrent insurance authorizations.

·         Oversee medical necessity reviews using payer-specific guidelines and industry-recognized criteria.

·         Manage peer-to-peer reviews, appeals, and denial prevention strategies.

·         Monitor key performance indicators, including authorization turnaround times, denial rates, and length of stay.

·         Ensure compliance with CMS, Joint Commission, HIPAA, and applicable state regulations.

·         Develop and implement Utilization Review policies, procedures, and best practices.

·         Supervise, mentor, and evaluate Utilization Review staff.

·         Collaborate with interdisciplinary teams to support quality patient care and financial performance.

·         Participate in Quality Assessment and Performance Improvement (QAPI) initiatives.

Qualifications

·         Minimum of LPN credentials required. A degree from an accredited college or university with emphasis in a related behavioral healthcare field or in nursing preferred.

·         Minimum of three (3) years of Utilization Review, Case Management, or Utilization Management experience in an acute care or behavioral health setting.

·         Previous leadership or supervisory experience preferred.

·         Knowledge of Medicare, Medicaid, Managed Care, and Commercial insurance authorization processes.

·         Strong understanding of behavioral health documentation standards and reimbursement guidelines.

·         Excellent communication, leadership, organizational, and analytical skills.

Compensation & Benefits

·         Competitive salary based on experience

·         Comprehensive medical, dental, vision, and life insurance

·         Paid Time Off (PTO)

·         Retirement savings plan

·         Professional development opportunities

How to Apply

Qualified candidates are encouraged to submit a current résumé and cover letter for confidential consideration. Only candidates selected for an interview will be contacted.

Equal Employment Opportunity

Seaside Health System is committed to the principle of Equal Employment Opportunity for all employees and applicants. It is our policy to ensure that both current and prospective employees are afforded equal employment opportunity without consideration of race, religious creed, color, national origin, nationality, ancestry, age, sex, marital status, sexual orientation, or disability in accordance with local, state and federal laws.

Americans with Disabilities Act

Applicants as well as employees who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation. The organization shall determine reasonable accommodation on a case-by-case basis in accordance with applicable law.