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

Baton Rouge Orthopaedic Clinic

Physical Therapist

Brusly, LA · On-site

$1.6K - $2.1K/wk

Utilization Review, Quality Assurance, Program Evaluation; Infection Control, and Safety Committee activities. * Develops and maintains relationships with physicians and other referral sources to ...

Ontario Trillium Foundation

Physical Therapist

Brusly, LA · On-site

$80 - $100/hr

Utilization Review, Quality Assurance, Program Evaluation; Infection Control, and Safety Committee activities. * Develops and maintains relationships with physicians and other referral sources to ...

State of Louisiana

Pharmacist 4

Baton Rouge, LA · On-site

$8.9K - $16K/mo

Oversees pharmacy program operations, including reimbursement methodologies, claims processing, drug utilization review, claims reconciliation, and the fiscal intermediary's pharmacy-related ...

Integrated Resources INC

Case Manager 3

Baton Rouge, LA · On-site

$19.25 - $24.75/hr

The Behavioral Health Concurrent Review Clinician utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Applies critical thinking ...

Baton Rouge Orthopaedic Clinic

Physical Therapist

Brusly, LA · On-site

$1.6K - $2.1K/wk

Utilization Review, Quality Assurance, Program Evaluation; Infection Control, and Safety Committee activities. * Develops and maintains relationships with physicians and other referral sources to ...

Baton Rouge Orthopaedic Clinic

Physical Therapist

Brusly, LA · On-site

$1.6K - $2.1K/wk

Utilization Review, Quality Assurance, Program Evaluation; Infection Control, and Safety Committee activities. * Develops and maintains relationships with physicians and other referral sources to ...

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Utilization Review information

See Baton Rouge, LA salary details

$16

$33

$54

How much do utilization review jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for utilization review 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.

What is a utilization review?

A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.

What does a utilization review do?

A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.

What are the key skills and qualifications needed to thrive in utilization review?

To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.

How do I get into a utilization review?

To become a utilization review specialist, typically a healthcare or related degree such as nursing, health administration, or social work is required. Certification in case management or utilization review, like the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects, and strong analytical and communication skills are essential for success in the role.

Is utilization review a stressful job?

Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, often under strict deadlines and documentation requirements. The job can be stressful due to high workload, the need for accuracy, and managing complex cases, but stress levels vary based on work environment and individual coping skills.

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

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

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

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

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

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

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

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

Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Baton Rouge, LA as of September 2026, with employment types broken down into 80% Full Time, and 20% Part Time. Highlights an 60% In-person, and 40% Remote job distribution, with an average salary of $68,998 per year, or $33.2 per hour.

Inpatient Utilization Review Clinician, Behavioral Health

Baton Rouge, LA • On-site

Centene Corporation
Health Care and Social Assistance • 10K+ employees
Learn more about Centene Corporationexternal

$27.02 - $48.55/hr

Other

Medical, Retirement, PTO

Re-posted 26 days ago

Centene rating

8.4

Company rating: 8.4 out of 10

Based on 406 frontline employees who took The Breakroom Quiz

12th of 898 rated healthcare providers

Job description

Position Purpose: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care and services related to mental health and substance abuse are medically appropriate.

Key Details: This position is Tuesday-Saturday or Wednesday - Sunday 8am to 5pm with holiday rotation.

  • Evaluates member’s treatment for mental health and substance abuse before, during, and after services to ensure level of care and services are medically appropriate

  • Performs prior authorization reviews related to mental health and substance abuse to determine medical appropriateness in accordance with regulatory guidelines and criteria

  • Performs concurrent review of behavioral health (BH) inpatient to determine overall health of member, treatment needs, and discharge planning

  • Analyzes BH member data to improve quality and appropriate utilization of services

  • Provides education to providers members and their families regrading BH utilization process

  • Interacts with BH healthcare providers as appropriate to discuss level of care and/or services

  • Engages with medical directors and leadership to improve the quality and efficiency of care

  • Formulates and presents cases in staffing and integrated rounds

  • Performs other duties as assigned.

  • Complies with all policies and standards.

Education/Experience: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 2 – 4 years of related experience.

License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state required.

Master’s degree for behavioral health clinicians required.

Clinical knowledge and ability to review and/or assess treatment plans related to mental health and substance abuse preferred.

Knowledge of mental health and substance abuse utilization review process preferred.

Experience working with providers and healthcare teams to review care services related to mental health and substance abuse preferred.

License/Certification:

  • LCSW- License Clinical Social Worker required or

  • LMHC-Licensed Mental Health Counselor required or

  • LPC-Licensed Professional Counselor required or

  • Licensed Marital and Family Therapist (LMFT) required or

  • Licensed Mental Health Professional (LMHP) required or

  • RN - Registered Nurse - State Licensure and/or Compact State Licensure required

Pay Range: $27.02 - $48.55 per hour

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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