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Utilization Review Rn Jobs in Baton Rouge, LA (NOW HIRING)

Healthcare Support Staffing

HEDIS Nurse

Baton Rouge, LA

$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 ...

State of Louisiana

REGISTERED NURSE 3

Baton Rouge, LA · On-site

$4.8K - $8.7K/mo

This posting may be used to fill other RN vacancies within ELMHS The Mission of ELMHS is to provide ... Review medications/supplies stored in the medicine room for expiration date. Count/document ...

Imh

Registered Nurse Med Onc

New Roads, LA · On-site

$36.71 - $56.17/hr

The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability ... WhileHiredScore assists in reviewing applications, all final decisions are made byIntermountain ...

US Navy

Registered Nurse

Independence, LA

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

US Navy

Registered Nurse

Albany, LA

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

US Navy

Registered Nurse

Jackson, LA

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

US Navy

Registered Nurse

Livonia, LA

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

US Navy

Registered Nurse

Maringouin, LA

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

US Navy

Registered Nurse

Monticello, LA

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Baton Rouge, LA

Utilization Review Rn information

See Baton Rouge, LA salary details

$16

$33

$54

How much do utilization review rn jobs pay per hour?

As of Jun 24, 2026, the average hourly pay for utilization review rn in Baton Rouge, LA is $33.17, according to ZipRecruiter salary data. Most workers in this role earn between $26.20 and $38.08 per hour, depending on experience, location, and employer.

How does a Utilization Review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

How do I become a utilization review RN?

To become a utilization review RN, you typically need to hold a valid registered nurse (RN) license and have experience in clinical nursing. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or Utilization Review Certification (URAC) can enhance job prospects, and strong knowledge of medical coding, insurance policies, and healthcare regulations is important.

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

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

What does an RN utilization review do?

An RN utilization review evaluates medical records and treatment plans to determine the appropriateness, necessity, and efficiency of healthcare services. They ensure compliance with insurance policies and clinical guidelines, often using electronic health records and requiring knowledge of coding and documentation standards. This role supports cost-effective patient care and involves collaboration with healthcare providers and insurance companies.

How to make $300,000 a year as a nurse?

To earn $300,000 annually as a Utilization Review RN, professionals typically need extensive experience, advanced certifications such as CCM or ANCC, and may work in high-paying settings like insurance companies or healthcare consulting firms. Increasing specialization, taking on leadership roles, or working overtime can also boost income, but reaching this level often requires a combination of skills, experience, and strategic career moves.

What is the difference between Utilization Review Rn vs Case Manager?

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

How to make $150,000 as a nurse?

A Utilization Review RN can earn $150,000 by gaining extensive experience, obtaining certifications such as CCM or ANCC, and working in high-paying settings like insurance companies or managed care organizations. Advanced skills in case management, strong clinical knowledge, and sometimes working overtime or in leadership roles can also contribute to higher earnings.

What is a Utilization Review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.
What are the most commonly searched types of Utilization Review Rn jobs in Baton Rouge, LA? The most popular types of Utilization Review Rn jobs in Baton Rouge, LA are:
What are popular job titles related to Utilization Review Rn jobs in Baton Rouge, LA? For Utilization Review Rn jobs in Baton Rouge, LA, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Baton Rouge, LA look for? The top searched job categories for Utilization Review Rn jobs in Baton Rouge, LA are:
What cities near Baton Rouge, LA are hiring for Utilization Review Rn jobs? Cities near Baton Rouge, LA with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Baton Rouge, LA as of June 2026, with employment types broken down into 88% Full Time, 10% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $68,998 per year, or $33.2 per hour.

Registered Nurse

Interventional Pain Institute, LLC

Baton Rouge, LA • On-site

$28 - $33/hr

Other

Posted 19 days ago

Job description

Position Description: At Interventional Pain Management, we are seeking an experienced, organized, and clinically confident Registered Nurse (RN) to support our Practice on a part-time basis. This role will serve as a key clinical leader for ongoing patient care, nurse triage, procedural coordination, and advanced pain management services.Primary Responsibilities:Nurse Phone Line & Ongoing Patient Care (Primary Function)Serve as the primary clinical contact for patients via a dedicated nurse phone line.Respond to patient questions related to day-to-day pain management, including medication use, refills, symptom changes, visit follow-up, and care coordination.Provide patient education, clinical guidance, and reassurance within RN scope of practice.Identify red-flag symptoms and escalate or intervene appropriately.Document all patient communications accurately in the electronic medical record (EMR).Procedural & Post-Procedure Patient SupportAddress patient questions related to interventional pain procedures, including preparation, medication management, and recovery expectations.Assess post-procedure symptoms and escalate concerning findings to the provider.Coordinate with providers and clinic staff to ensure continuity of care.Procedure Clearance Management & Diagnostic SupportManage and coordinate all medical clearances required for interventional pain procedures and surgeries. Obtain, review, and organize clearance documentation for anesthesia and procedures.Perform venipuncture (blood draws) as required.Perform EKGs, provide preliminary reads with proper training, and escalate abnormal findings to the provider for final interpretation.Coordinate with external providers including primary care, cardiology, pulmonology, endocrinology, and other specialists.Ensure all required documentation is completed and documented prior to procedures.Intrathecal Pain Pump Management (RN-Specific)Perform intrathecal pain pump refills per provider orders and clinic protocols. Monitor patients during and after refills for safety.Manage intrathecal pain pump medication ordering, inventory, and documentation. Communicate pump-related concerns to the provider.Documentation & Administrative Nursing SupportComplete and manage FMLA, disability forms, handicap placards, and other medical documentation. Support care coordination and clinical workflows.Qualifications:Current Registered Nurse (RN) license (State of Louisiana or eligible). Experience in outpatient, procedural, or specialty clinics.Strong clinical assessment and communication skills.Preferred Experience:Pain management or interventional experience.Experience with intrathecal pain pumps.Nurse triage experience.Spanish fluency is considered an exceptional asset and will be given strong consideration. $28.00 - $33.00 Hourly

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