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

Baton Rouge General

Pharmacy Resident

Baton Rouge, LA · On-site

$13.75 - $16.75/hr

... utilization reviews/monitors. • Documents significant therapeutic interventions and tracks impact of clinical outcomes as required • Serves as source of drug information and education for ...

Baton Rouge General

Pharmacy Resident

Baton Rouge, LA · On-site

$15.25 - $18.50/hr

... utilization reviews/monitors. • Documents significant therapeutic interventions and tracks impact of clinical outcomes as required • Serves as source of drug information and education for ...

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All JobsUtilization Reviewer JobsUtilization Reviewer Jobs in Baton Rouge, LA

Utilization Reviewer information

See Baton Rouge, LA salary details

$27.1K

$33.2K

$38.5K

How much do utilization reviewer jobs pay per year?

As of Aug 10, 2026, the average yearly pay for utilization reviewer in Baton Rouge, LA is $33,242.00, according to ZipRecruiter salary data. Most workers in this role earn between $29,700.00 and $36,700.00 per year, depending on experience, location, and employer.

What is the difference between Utilization Reviewer vs Medical Coder?

AspectUtilization ReviewerMedical Coder
Required CredentialsTypically requires healthcare-related certifications, such as RHIT, RHIA, or CPCUsually requires coding certifications like CPC, CCS, or CCS-P
Work EnvironmentHealthcare facilities, insurance companies, or utilization review organizationsHospitals, clinics, or medical billing companies
Employer & Industry UsageUsed in insurance, managed care, and healthcare administrationUsed in medical billing, coding, and health information management

While both roles work within healthcare settings, Utilization Reviewers focus on evaluating the necessity of medical services for insurance and care management, whereas Medical Coders translate medical records into standardized codes for billing and documentation. Understanding these differences helps professionals choose the right career path or job search focus.

How does a utilization reviewer typically collaborate with healthcare providers to ensure appropriate patient care?

Utilization Reviewers work closely with physicians, nurses, and other healthcare professionals to assess the necessity and efficiency of medical services provided to patients. They review clinical documentation, verify that treatments meet established guidelines, and may discuss care plans directly with providers to clarify information or suggest alternatives. This collaboration ensures that patients receive appropriate care while controlling costs and complying with insurance or regulatory requirements. Effective communication and a thorough understanding of medical protocols are essential for success in this role.

What does a utilization reviewer do?

A Utilization Reviewer is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient records, treatment plans, and insurance policies to ensure that care meets established guidelines and standards. Their role helps control healthcare costs while maintaining quality patient care and ensuring compliance with regulatory requirements. Utilization Reviewers often communicate with healthcare providers, insurance companies, and patients to gather information and make informed decisions.

What does a utilization reviewer do?

There are different types of Utilization Reviewer jobs, including Nurse Utilization Reviewers, Insurance Utilization Reviewers, Speech Therapy, Physical Therapy, and Occupational Therapy Utilization Reviewers. Regardless of the area of focus, a Utilization Reviewer is responsible for setting best practices, reviewing healthcare program requirements, ensuring the quality of care, controlling costs, and developing and implementing initiatives for review processes. Utilization Reviewers ensure compliance of programs, regularly audit patient and client records, work with staff to implement best practices and correct problem areas, monitor industry trends, and remain up-to-date and train others on industry standards and requirements.

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

To thrive as a Utilization Reviewer, you need a clinical background (such as RN or LCSW), in-depth knowledge of medical terminology, and an understanding of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or URAC accreditation is typically required. Strong critical thinking, attention to detail, and effective communication skills help in evaluating patient care and collaborating with providers. These competencies are crucial for ensuring appropriate, cost-effective care while maintaining compliance with healthcare standards.
More about Utilization Reviewer jobs
What are popular job titles related to Utilization Reviewer jobs in Baton Rouge, LA? For Utilization Reviewer jobs in Baton Rouge, LA, the most frequently searched job titles are:
What job categories do people searching Utilization Reviewer jobs in Baton Rouge, LA look for? The top searched job categories for Utilization Reviewer jobs in Baton Rouge, LA are:
What cities near Baton Rouge, LA are hiring for Utilization Reviewer jobs? Cities near Baton Rouge, LA with the most Utilization Reviewer job openings:
Utilization Reviewer jobs near you
Infographic showing various Utilization Reviewer job openings in Baton Rouge, LA as of August 2026, with employment types broken down into 95% Full Time, and 5% Part Time. Highlights an 86% In-person, and 14% Remote job distribution, with an average salary of $33,242 per year, or $16 per hour.

Pharmacy Resident

Job Patient Care Associate - MACU AM Baton Rouge General in Baton Rouge, Louisiana

Baton Rouge, LA • On-site

$15.25 - $18.50/hr

Full-time

Re-posted 5 days ago

Job description

Pharmacy Resident: PGY1 Pharmacy Practice Residency

Job Specific

The pharmacy resident optimizes patient care by promoting rational, safe, and cost-effective drug therapy. The residency program is designed to align with the framework and requirements of the ASHP Accreditation Standard for Pharmacy Practice Residents. Throughout the course of the program, the resident develops and sharpens advanced knowledge and skills in application of drug therapy for the prevention and treatment of human illness via a variety of experimental activities and projects as determined by the Residency Program Director.

Essential Job Functions:

Knows, understands, incorporates, and demonstrates the Organization's Mission, Vision, and Values in behaviors, practices, and decisions

Under the supervision of a designated preceptor, reviews and evaluates patient's drug/medical history to make recommendations that optimize drug therapy, by providing drug information and evaluation of medical literature during rounds with physicians, through verbal or written consultations, and drug utilization reviews/monitors.

Documents significant therapeutic interventions and tracks impact of clinical outcomes as required

Serves as source of drug information and education for patients and other health care providers.

Organizes, prepares, and presents patient medication education information in both written and verbal formats.

Provides formal education to Pharmacists, Pharmacy Residents and other healthcare practitioners through in-services or lectures and publications.

Conducts pharmacy practice research by collecting, analyzing, trending, collating, and evaluating data to be synthesized into reports (e.g., formulary evaluation, adverse drug reactions, ongoing monitors, non-formulary requests or specific drug usage evaluations) for action by committees.

Contributes to the medical community and pharmacy practice by presenting research at meetings or publishing results in journals.

Promotes interdisciplinary teamwork by working on Clinical Pathways, committees, and task forces.

Maintains clinical expertise by obtaining continuing education credits, reading, and evaluating literature and attending seminars.

Performs the functions of a pharmacist per the pharmacist job description, including preparing, compounding, and dispensing prescription and non-prescription medications, IV medications and solutions and other required drug therapies pursuant to meeting the prescription medication needs of inpatients and outpatients

Successfully completes the American Society of Health System Pharmacists residency goals and objectives.

Performs other duties as assigned or required.

Minimum Qualifications: Successful completion of PharmD from an ACPE accredited school of pharmacy. Eligible for licensure in the state of Louisiana.
Certification Required: All the following: Louisiana State Board of Pharmacy Pharmacist within 60 days from the start of the residency. Basic Life Support (BLS) certification upon hire.

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