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

UMR

Registered Nurse - | , | Group

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 ...

divvyDOSE

Registered Nurse - | , | Group

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 ...

UnitedHealthcare

Registered Nurse - | , | Group

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 ...

Healthcare Support Staffing

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 ...

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Utilization Review Rn information

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$66

How much do utilization review rn jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for utilization review rn 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.

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.

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.

How to get into utilization review as a registered nurse?

To become a utilization review RN, you typically need a valid registered nurse license and experience in clinical settings. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or knowledge of medical coding and insurance processes can enhance your qualifications. Gaining experience in case management or health insurance companies can also improve your chances of entering the field.

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.

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 August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% 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.

Registered Nurse - Correctional Health

Parkland Health

Baton Rouge, LA • On-site

Full-time

Posted 3 days ago

New

Parkland Health and Hospital System rating

8.2

Company rating: 8.2 out of 10

Based on 90 frontline employees who took The Breakroom Quiz

53rd of 887 rated healthcare providers

Job description

Full Time

PRIMARY PURPOSE

The RN is a licensed professional who uses the Parkland nursing professional practice model to coordinate patient care delivery by the health care team. Using the nursing process, the RN assesses the patient, identifies nursing diagnoses based on responses to health problems, develops and implements an individualized plan of care, and evaluates the patient's response. The RN utilizes knowledge of patient needs and the healthcare environment to assist patients to transition through the healthcare encounter without any preventable complications or delays. The RN delegates interventions to health care personnel based on the Texas Nursing Practice Act, each patient's condition and the competencies of the employee.

MINIMUM SPECIFICATIONS

Education

  • Must be a graduate from an accredited school of nursing.

Experience

  • Nine (9) months of professional nursing experience preferred.
  • If less than 9 months RN experience, a Nurse residency is required. LVN experience does not waive this requirement.

Equivalent Education and/or Experience: None.

Certification/Registration/Licensure

  • Must have current RN license or valid temporary permit with the Texas Board of Nursing or valid Compact RN license.
  • Must have current healthcare provider BLS for Healthcare Providers certification from one of the following:
    • American Heart Association
    • American Red Cross
    • Military Training Network

Skills or Special Abilities

  • Provides care to assigned patient population in accordance with the current State of Texas Nursing Practice Act, established protocols, multidisciplinary plan of care, and clinical area specific standards.
  • Provides continuous assessment, consults with other team members as required and provides nursing care which demonstrates patient centered/patient valued care. - Exercises independent judgment in providing nursing care.
  • Must be able to demonstrate effective interpersonal skills and possess basic computer literacy and written communication skills.
  • Must be able to communicate effectively with patients. As applicable, will be required to demonstrate acceptable knowledge of nursing standards of care for specialty care area.

Responsibilities

  • Serves as a patient advocate, by focusing on patient needs, patient rights, confidentiality, and religious and cultural preferences.
  • Maintains positive working relationships with all Parkland internal and external customers, employees, etc. Serves as a resource for patients and other healthcare team members. Provides patient care educational information and training to patient and family members.
  • May serve as a resource for specific clinical patient care issues. May participate in community outreach activities (such as health fairs, community collaborations or outreach clinics) as assigned.
  • Maintains and updates knowledge of sanitation, infection control, safety, supplies, equipment, appropriate utilization of supplies and materials.
  • Completes appropriate documentation. Maintains accurate and timely entries and notations in patient care records and hospital documents. Ensures that all records and documents meet the standards, goals, and objectives of the assigned department and Parkland.
  • Seeks and utilizes direction from more experience staff and team members as needed. May work with other staff in providing direction to non-nursing staff. Participates in information exchanges with nursing and other Parkland staff to support the mission, vision, and values of the department and Parkland.

What Parkland Health and Hospital System employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Parkland Health and Hospital System

Sourced by ZipRecruiter

Parkland Health and Hospital System, based in Dallas, TX, US, is a reputed entity in the healthcare industry. Accessible through their website parklandhealth.org, this distinguished organization operates within the public sector, primarily providing medical care and services. Parkland Health was founded with a mission to take healthcare to people who need it the most and ever since its inception it has staunchly adhered to this principle. The hospital is acknowledged for its unyielding dedication to patient care, its world-class staff, and its innovative medical breakthroughs. Alongside its traditional healthcare offerings, Parkland also provides specialized services such as burn treatment and poison control, cementing their position as a comprehensive provider of critical care.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Dallas, TX, US

Year founded

1954

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