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Utilization review nurse jobs in Baton Rouge, LA

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  • Utilization Management Nurse

    Centerwell

    Utilization review nurse job in Baton Rouge, LA

    **Become a part of our caring community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent service to others. **Use your skills to make an impact** **Required Qualifications** + Active unrestricted RN license with the ability to obtain Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work independently and within a team setting + Willing to work in multiple time zones + Strong written and verbal communication skills + Attention to detail, strong computer skills including Microsoft office products + Ability to work in fast paced environment + Ability to form positive working relationships with all internal and external customers **Preferred Qualifications** + Education: BSN or bachelor's degree in a related field + Experience with Physical Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare + Current nursing experience in Hospital, SNF, LTAC, DME or Home Health. + Bilingual **Alert** Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. **Interview Format - HireVue** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. **Work-At-Home Requirements** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if approved by leadership. + Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. **Benefits** Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including: + Health benefits effective day 1 + Paid time off, holidays, volunteer time and jury duty pay + Recognition pay + 401(k) retirement savings plan with employer match + Tuition assistance + Scholarships for eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-25-2025 **About us** About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************
    $71.1k-97.8k yearly Easy Apply 31d ago
  • QM Nurse Consultant

    CVS Health 4.6company rating

    Utilization review nurse job in Baton Rouge, LA

    At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** As a QM Nurse Consultant you will be responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets data obtained from clinical records or systems and uses clinical decision making to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider claims. + Independently coordinates the clinical resolution with clinician/MD support as required. + Considers all documentation provided including medical records and system documentation to evaluate post-service claims for payment based on clinical policies, legislation, regulatory requirements, and plan benefits. + Review requires navigation through multiple system applications as well as potential requirement to outreach to internal department or providers. + Accurately applies review requirements to assure case is reviewed according to all company policies and procedures as well as state and federal laws and regulations. + Adhere to company policies regarding confidentiality to protect member information. **Required Qualifications** - 5+ years of clinical experience required - 2+ years of experience as a Registered Nurse - Must have active, current and unrestricted RN licensure in state of residence - 1+ years of experience using Microsoft Office products, including Outlook and Excel, and previous experience using Internet Explorer and Google Chrome to effectively utilize review resources and conduct reviews. - Must be willing to work Monday through Friday 8:00am - 5:00pm in time zone of residence **Preferred Qualifications** - Utilization Management review - Managed Care experience **Education** Associates degree required **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $54,095.00 - $155,538.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 12/13/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
    $54.1k-155.5k yearly 60d+ ago
  • Travel Nurse Practitioner

    Monogram Health Professional Services 3.7company rating

    Utilization review nurse job in Baton Rouge, LA

    Job DescriptionPosition: Travel Nurse Practitioner Monogram Health is looking for a skilled Nurse Practitioner eager for the opportunity to make a difference in patients' lives. The Monogram Travel Nurse Practitioner plays a critical role in providing access to comprehensive care for underserved patients our Monogram Health network reach. Also, helping patients improve their quality of life in the home and slow the progression of kidney disease and multiple other chronic illnesses, enabling positive health outcomes. Your Impact: As a Travel Nurse Practitioner, you will be responsible for the delivery of personalized and compassionate care to patients primarily with CKD through ESRD. Monogram's Travel NPs will become nationwide float providers to the members in areas where our local clinicians are unable to reach and in areas where we are rapidly growing. Primary duties include patient health assessment, creating strategies to improve or manage a patient's health, and introducing habits for health promotion. In part of completing this care for patients, your responsibilities will include maintaining accurate patient records, scheduling, and administering follow-up appointments to patients as required across multiple markets. Highlights & Benefits Opportunity to work in a dynamic, fast-paced and innovative value-based provider organization that is transforming the delivery of kidney care Competitive salary Comprehensive medical, dental, vision and life insurance (1099 options also available) Flexible paid leave and vacation policy 401(k) plan with matching contributions Roles and Responsibilities Travels nationwide to conduct in-home assessments, which include comprehensive annual wellness exams, focused screenings, or other visits both in the patients' home and in the virtual environment Ability to travel out of town for up to 75% of the month during the work week Counsels and educates patients and families about benefits and programs available to help them live healthier lives Documents items such as: appropriate chief complaint, all applicable diagnosis, past medical, family, and social history, review of systems, examinations, medications, allergies, assessment, and plan Responsible for the coordination of care with primary care providers, specialists, and appropriate ancillary services Completes all documentation and paperwork in a timely manner Maintains quality of care standards as defined by the practice This position will not be office-based but will be based in state in which employed and will need to attend periodic training/meetings outside of that state Deliver evidence-based, timely care in a manner that reduces avoidable hospitalizations, maximizes quality of life, and puts patient health and satisfaction first Prescribe medications, order tests, and collaborate with patient's Monogram physician Perform effectively, as reflected by improved patient quality outcomes, which will be measured and reported daily Facilitates closing gaps in care by educating patients about preventive monitoring and working with physician practices to schedule diagnostic testing Assists patients with enrolling to access educational videos Participates in the integrated care team meetings Knowledge of disease diagnosis and prevention Make assessment of patient's health status Implement a plan consistent with appropriate plan of care Follow-up and evaluate patient's status Other duties as assigned Position Requirements Active and unrestricted Registered Nurse and Nurse Practitioner Board certified for appropriate licensure (NP: ANCC/AANP) Current and unrestricted DEA certificate, or eligibility Ability to travel extensively by air and utilize rental vehicles Ability to work without direct supervision and practice autonomously Access to transportation, a valid driver's license, and car insurance Must be proficient with medical instruments and equipment required by the work Knowledge of computer-based data management programs and information systems, as well as medical records and point-of-interview technology Ability to communicate effectively in verbal and written form with retail and medical partners at various levels, patients, family members, physicians and representatives of the community Sound understanding of all federal and state regulations including HIPAA and OSHA 2 or more years of direct patient care required About Monogram Health Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person's health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders. Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient's healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home. Monogram Health's personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum. #TNP
    $54k-105k yearly est. 12d ago
  • New Graduate Nurse

    Fresenius Medical Care North America 4.3company rating

    Utilization review nurse job in Baton Rouge, LA

    **PURPOSE AND SCOPE:** Functions as part of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a Staff Registered Nurse, to ensure provision of quality patient care on a daily basis in accordance with FMS policies, procedures, and training. Supports the FMCNA's mission, vision, values, and customer service philosophy. Supports the FMCNA commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the FMCNA Quality Enhancement Goals (QEP). Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies. Employees hired into this position will be required to obtain their nursing license and registration within the timeframe outlined in state specific regulations, or within 90 days from hire date, whichever comes sooner. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** **STAFF RELATED:** + Directs Patient Care Technician's provision of safe and effective delivery of chronic hemodialysis therapy to patients in compliance with standards outlined in the facility policy procedure manuals, as well as regulations set forth by the corporation, state, and federal agencies. + Delegates tasks to all direct patient care staff including but not limited to LVN/LPNs, Patient Care Technicians, and Dialysis Assistants. + Assesses daily patient care needs and develops appropriate patient care assignments. + Routinely monitors patient care staff for appropriate techniques and adherence to facility policy and procedures. + Participates in staff training and orientation of new staff as assigned + Participates in all required staff meetings as scheduled. **PATIENT RELATED:** Education: + Ensures educational needs of patients and family are met regarding End Stage Renal Disease (ESRD). + Provides ongoing education to patients regarding their renal disease, vascular access and dialysis therapy, and other related health conditions. + Discusses with patient, and records education related to diet/fluid and medication compliance. + Provides patient specific detailed education regarding adequacy measures where applicable - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM). + Ensures transplant awareness, modality awareness, and drive catheter reduction. + Educates patients regarding laboratory values and the relationship to adequate dialysis therapy, compliance with treatment schedule, medications, and fluid. Dialysis Treatment: + Provides safe and effective delivery of care to patients with ESRD. + Accurately implements treatment prescriptions including Sodium (Na) modeling prescription, and Ultrafiltration modeling (where appropriate) to ensure stable treatment therapy as indicated. + Assesses patients' response to hemodialysis treatment therapy, making appropriate adjustments and modifications to the treatment plan as indicated by the prescribing physician. Communicates problems or concerns to the Team Leader or physician. + Identifies and communicates patient related issues to Team Leader or physician. + Initiates Initial and Annual Nursing Assessment, and ongoing evaluation and documentation of patient care needs according to FMC Policies and Procedures. + Actively participates in the pre evaluation, initiation, monitoring, termination, access homeostasis, and post evaluation of patients receiving hemodialysis treatment therapy according to established FMC procedures. + Takes appropriate intervention for changes in patient adequacy status and troubleshooting access flow issues as identified by OLC/AMP yellow lights. + Provides, supervises (if applicable), and monitors hemodialysis access care according to established procedures. + Implements, administers, monitors, and documents patient's response to prescribed interdialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate blood supplier. + Ensures accurate and complete documentation by Patient Care Technician on the Hemodialysis Treatment Sheet. Laboratory-related: + Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab requisitions for Spectra or alternate lab. + Ensures correct labs tubes are utilized for prescribed lab specimens and that lab draw and processing procedures are performed appropriately for all lab samples. + Identifies and ensures appropriate follow-through regarding missed labs and specimens reported to be insufficient according to company policies and procedures. + Ensures all specimens are appropriately packaged according to Department of Transportation (DOT) policies and procedures relating to shipment of blood or body fluid specimens and potentially hazardous material. + Ensures that all labs are directed and delivered to appropriate labs. + Reports alert/panic and abnormal labs results to appropriate physician. + Ensures lab results are forwarded to physicians as requested. General duties: + Enforces all company approved policies and procedures, as well as regulations set forth by state and federal agencies and departments. + Maintains overall shift operation in a safe, efficient, and effective manner. + Act as a resource for other staff members. + Routinely meets with the Clinical Manager to discuss personnel and patient care status, issues, and information. + Collaborate and communicate with physicians and other members of the healthcare team to interpret, adjust, and coordinate care provided to the patient. + Provides assistance as needed to patients regarding prescription refills according to FMCNA Policies. + Ensures all physician orders are transcribed and entered into the Medical Information system in a timely manner. + Oversees all documentation of patient information. + Maintains facility drug list for all required stock medications. + Maintains competency with all emergency operational procedures, and initiates CPR and emergency measures in the event of a cardiac and/or respiratory arrest. + Ensures verification and availability of adequate emergency equipment. + Ensures provision of appropriate vaccinations, immunizations, and annual Tuberculosis (TB) testing. + Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification if indicated. + Administers PRN medications as prescribed and completes appropriate documentation of assessment of effectiveness. + Maintains appropriate recording of controlled substances as required by law. + Assists with the coordination of patient transportation if necessary. **MAINTENANCE/TECHNICAL:** + Ensures a clean, safe, and sanitary environment in the dialysis facility treatment area. + Ensures competency in the operation of all dialysis-related equipment safely and effectively. + Ensures all patient stations, including machines and chairs, are clean and free of blood and placed appropriately. + Ensures that all blood spills are immediately addressed according to FMCNA Bloodborne Pathogen Control Policies. **MEDICAL RECORDS & DOCUMENTATION:** General + Ensures all relevant data including physician orders, lab results, vital signs and treatment parameters, and patient status are documented appropriately and entered into Medical Information System. + Ensures all appropriate patient related treatment data is entered into the Medical Information System. + Ensures all FMCNA policies regarding patient admission, transfer, and discharge are appropriately implemented. + Ensures and verify accuracy of Patient Care Technician documentation. Daily + Reviews and ensures appropriate daily completion of Hemodialysis Treatment Sheets by all patient care staff. + Ensures that all appropriate procedures are followed regarding opening and closing procedures, inclusive of monitoring that all staff and patients have safely left the premises. Monthly + Initiates, documents, and completes ongoing Continuous Quality Improvement (CQI) activities including monthly reports. + Completes monthly nurses' progress note. + Ensures patient medical records are complete with appropriate information, documentation, and identification on each page (Addressograph label is on all chart forms). + Reviews transplant status and follows established procedure regarding appropriate action to be taken. + Completes patient care plans for new patients within the initial 30 days or any patients deemed unstable requiring monthly patient care plans. + Completes any long-term programs that are due. Annually + Completes initial and annual Nursing History and Assessment physical. + Ensures completion of Annual Standing Order Review with each physician as required. **OTHER:** + As a condition of continued employment, you are required to obtain and maintain any required credentials or certifications necessary for your position in an active and valid status (including renewal of such credentials or certifications prior to any expiration date). In the event that your credential or certified status changes, you must notify your supervisor immediately. + Capable of working in a challenging environment which requires the ability to handle demanding situations, multitasking, and remaining flexible to changing needs. + Maintain regular and punctual attendance. + Perform other related duties as assigned. **_Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions._** **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + The position provides direct patient care that regularly involves heavy lifting and moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. up as high as 5 feet. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodation can be made. **SUPERVISION:** + None **EDUCATION** **:** + Graduate of an accredited School of Nursing. + Current appropriate state Temporary Permit. + Must meet the practice requirements in the state in which he or she is employed. **EXPERIENCE AND REQUIRED SKILLS** **:** + 0 - 1 year's related experience. **ACKNOWLEDGEMENT:** I acknowledge that I have read and accepted this . I understand what is expected of me in this position, and I am able to perform the essential functions as outlined with or without reasonable accommodation. Furthermore, I understand that the duties and responsibilities listed in this are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. If I have any questions about duties and responsibilities not specified in this job description that I am asked to perform, I should discuss them with my immediate supervisor or my Human Resources representative. **ADDENDUM:** Managers in each state must determine if their state regulations permit employees to operate in this capacity, as well as the allowable duties and practice restrictions if permitted. Managers should consult their state-specific regulations at: ********************************************************************************************************************************************************** . For additional information please contact your Regional Education Coordinator. The rate of pay for this position will depend on the successful candidate's work location and qualifications, including relevant education, work experience, skills, and competencies. Hourly Rate: $38.00-$55.36 for the Denver, CO locations. Other locations outside the state of CO will vary from this range. Benefits Overview: This position offers a comprehensive benefits package, including medical, dental, and vision insurance, a 401(k) with company match, paid time off, and parental leave. **Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**
    $38-55.4 hourly 60d+ ago
  • Aesthetic NP/PA Injector

    Diamond Accelerator

    Utilization review nurse job in Baton Rouge, LA

    Job Description Job Title: Aesthetic Injector -NP or PA Compensation: $65 per hour, Full-Time opportunity About Us At Coco Beauty Bar, we believe confidence is the ultimate beauty secret. Our boutique aesthetics practice in Baton Rouge is dedicated to providing safe, natural, and transformative results in a luxury, client-focused setting. We have an established patient base, but we are growing and looking for a Full-Time skilled Nurse Practitioner or Physician Assistant Injector to join our team! Why Join Us? Competitive pay at $65/hour Supportive, collaborative work environment Established patient base with room to grow Opportunities for continuing education and advanced training A culture built on professionalism, artistry, and exceptional patient care What You'll Do Perform injectable treatments including neurotoxins, dermal fillers, and other non-surgical procedures Conduct thorough consultations, listen to patient goals, and design personalized treatment plans Educate patients on treatments, pre- and post-care, and realistic expectations Deliver safe, consistent, and natural-looking results that build patient trust and loyalty Document treatments accurately and maintain compliance with clinical protocols Collaborate with our aesthetics team to elevate the patient experience What We're Looking For Licensed Nurse Practitioner (NP) or Physician Assistant (PA-C) in Louisiana 2+ years of injecting experience in aesthetics or cosmetic medicine (required) Strong knowledge of facial anatomy and advanced injection techniques Excellent communication and relationship-building skills Passion for aesthetics and dedication to continuous growth in the field If you're a skilled injector who thrives in a supportive, client-first environment and wants to grow with a forward-thinking practice, we'd love to hear from you! Apply today and help our patients look-and feel-their absolute best.
    $36k-60k yearly est. 3d ago
  • Headquarter Nurse

    Rejuvime Medical

    Utilization review nurse job in Baton Rouge, LA

    Job Details Baton Rouge, LA Full Time 2 Year Degree None Health CareDescription Providing care & education to patients regarding questions on treatments received as well as recommended treatments from Provider. Role and Responsibilities: Educate patients on treatments recommended by the provider as well as treatments received. Act as a liaison between patient and provider on questions and concerns. Answers patients calls and determines how to assist them. Works as part of a health care team to assess patient needs, plans and modifies care, and implements interventions. Some travel required to Baton Rouge area clinics based on staffing needs basis (Baton Rouge & Prairieville). Other duties as assigned. Qualifications Minimum Education and Experience Requirements: Graduate of an accredited nursing program Current state licensure required Preferred Education or Experience: 1 years of related experience Physical Requirements: Prolonged periods of sitting at a desk and working on a computer. Must be able to lift 15 pounds at times. Knowledge, Skills, and Abilities: Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction. Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times. Effective interpersonal skills Able to provide and receive information effectively and professionally.
    $36k-60k yearly est. 10d ago
  • HEDIS Nurse

    Healthcare Support Staffing

    Utilization review nurse job in Baton Rouge, LA

    HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Job Description Title: 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 medical records in order to abstract clinical data elements for HEDIS reporting Integrates data collected from a variety of electronic and paper sources Documents abstraction findings in HEDIS database tool Is responsible for meeting daily abstraction production goal Is responsible for meeting and maintaining quality requirement of 95% abstraction accuracy Hours for this Position: Mon-Fri daytime Advantages of this Opportunity: Competitive salary, negotiable based on relevant experience Benefits offered, Medical, Dental, and Vision Fun and positive work environment Qualifications Requirements: Clinical degree highly preferred, including, but not limited to: RN, LVN, LPN Experience working with HEDIS software (data entry, reporting) at least one year Experience in medical record review (vendor or health plan; onsite or fax/mail) Experience working in EMR systems Additional Information Are you an experienced Registered Nurse or Licensed Practical Nurse looking for a new job opportunity with a prestigious healthcare company? Are you interested in a project / contract job? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you! If you are interested in being considered for this position, please click the apply button below.
    $36k-60k yearly est. 60d+ ago
  • Nursing - ER

    Franciscan Missionaries of Our Lady Health System 3.6company rating

    Utilization review nurse job in Baton Rouge, LA

    Are you ready to take your Travel career to the next level? See places you have not seen before? Ventura's MedStaff tenured Recruiters are here to help you find your ideal contract; with over 50 years of combined experience. Markets have changed, but Ventura MedStaff has maintained a leader in the forefront of Therapy, Allied and Nursing opportunities. Our recruiters are here to help answer your questions and provide you with the most up to date information. Contracts run 8-13 weeks, with 36-40-hour guarantees, flexible start dates, and a mix of schedules. Contact one of our dedicated Recruiters to discuss more details. Ventura MedStaff benefits represent the care and compassion we provide for our clients. • Health, dental, vision, life, disability benefits and 401k • Tax free stipends when applicable • Gym discounts • Weekly pay • $750.00 referral bonus Please apply or contract us at: *********************** or ************
    $45k-56k yearly est. 13d ago
  • Medication Nurse

    Sunrise Senior Living 4.2company rating

    Utilization review nurse job in Baton Rouge, LA

    When you join Sunrise Senior Living, you will be able to use your unique skills to empower residents to live longer, healthier, and happier lives. Not only will you build meaningful relationships with residents, their families, and team members alike, you will also gain joy in serving others and deep fulfillment in your work. Explore how you can follow your passions and shed light on meaningful ways to serve, grow, and shine together. Sunrise Senior Living was again certified as a Great Place to Work by Activated Insights. This is the 8th time Sunrise has received this top culture and workplace designation, highlighting the special place Sunrise is to be a part of. COMMUNITY NAME Sunrise of Baton Rouge Job ID 2025-233645 JOB OVERVIEW The LPN Medication Care Manager is responsible for providing the highest degree of quality care and services by administering medication and treatments in a safe organized manner. Responsibilities include but are not limited to administration of medications, documentation of medication administration, conducting SHUs, and providing resident care while demonstrating the Mission for Sunrise Senior Living, “to champion the quality of life for all seniors” in accordance with federal, state/provincial, and local laws, standards and regulations and Sunrise Senior Living policies to promote the highest degree of quality care and services to our residents. RESPONSIBILITIES & QUALIFICATIONS Essential Duties As a part of the Sunrise team, supporting our Mission, Principles of Service and Core Values is a fundamental part of this job. Our foundational belief is the sacred value of human life. The unique responsibilities for this role include but are not limited to the essential functions listed as follows: Medication Administration Provide the highest degree of quality care and services by administering medication and treatments in a safe organized manner. Review, read, notate, and initial the electronic health record to document and learn about pertinent information about residents. Receive medication updates from Resident Care Director (RCD) or Wellness Nurse. Administer, assist with, and observe medications and treatments for each resident using the medication administration record and the Six Rights of Medication Pass (“Right” resident, medication, dosage, time, route, right to refuse). Ensure that medications are passed according to times utilizing a mobile medication cart. Document and initial as medications are given and ensure that appropriate documentation is completed for refusal or missed doses. Maintain confidentiality of all resident information including resident medication among other residents. Report all resident concerns and unavailable medication while administering the medication to the RCD or Wellness Nurse. Restock medication cart after all medication passes. Assist in checking medication regardless of packaging system. Assess the residents to determine need for “as needed medication” and appropriately document and report to supervisor. Count all narcotics with another Medication Care Manager (MCM) or Lead Care Manager (LCM) each shift and report discrepancies to the RCD or Wellness Nurse. Maintain and clean the Medication Room, medication carts, and treatment carts for neatness, cleanliness, availability of medications, and expired medications. Follow re-fill process for medications. Help residents maintain independence and promote dignity and physical safety of each resident adhering to the Sunrise Principles of Service. Strive to understand and respond to each resident with empathy, always remaining mindful of the resident's unique communication patterns, history, and basic human needs. Practice routinely good standard care precautions of cleanliness, hygiene, and health. Audit medication carts. Resident Care Notify RCD of any resident and/or family concerns. Attend and actively participates in daily Cross Over meetings facilitated by the LCM. Conduct Service and Health Updates as directed by RCD. Participate in the development of the Individualized Service Plans (ISP). Transcribe orders. Risk Management and General Safety Partner with community team to ensure community is in compliance with national/provincial regulations pertaining to occupational health and safety requirements, promoting Risk Management programs and policies, and adhering to safety rules and regulations. Practice safety procedures at all times including Personal Protective Equipment (PPE), fire extinguishers, Safety Data Sheets (SDS), and Lockout Tagout procedures. Report all accidents/incidents immediately. Report all unsafe and hazardous conditions/equipment immediately. Ensure any cords, carts, equipment, and other hazards are always kept out of the way, not blocking exits, and in compliance with fire codes. Comply with all infection control techniques, placement of bio-hazard containers, removal techniques, procedures, and policies. Understand and practice the proper method of attending to and disposing of, and the possibility of exposure to, blood borne pathogens, bodily fluids, infectious waste, sharp sticks, and hazardous materials. Report occupational exposures to blood, body fluids, infectious materials, sharp sticks and hazardous chemicals immediately. Ensure oxygen tanks are stored safely, exchange guest/resident's tanks when empty, and monitor to make sure liters of oxygen are at prescribed levels. Training and Contributing to Team Success Participate as a member of a team and commit to working toward team goals. Demonstrate in daily interactions with others, our Team Member Credo. Commit to serving our residents and guests through our Principles of Service. Contribute to the overall engagement programs and processes (customer and team member engagement) including participating in the team member engagement survey and engagement improvement planning workshops. Attend regular meetings; Town Hall, Department Team, Cross Over, Medication Technician and others as directed by the Supervisor/Department Coordinator. Attend regular training by RCD and neighborhood coordinators. May be designated as shift supervisor. May supervise other medication care managers. Maintain compliance in assigned required training and all training required by state/province or other regulating authorities as applicable to this role to ensure that Sunrise standards are always met. Perform other duties as assigned. Core Competencies Ability to make choices and decisions and act in the resident's best interest Ability to react and remain calm in difficult situations Ability to handle multiple priorities Possess written and verbal skills for effective communication and level of understanding Demonstrate good judgment, problem solving and decision-making skills Experience and Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed throughout this are representative of the knowledge, skills, and abilities required. LPN, LVN, or state/province specific licensed nurse credential In states/provinces where appropriate, must maintain certifications Maintain the following certifications and ongoing training and re-education as required by Sunrise and state/provincial regulations: o CPR and First Aid Must be at least 18 years of age Previous experience working with seniors preferred Desire to serve and care for seniors As applicable, all Sunrise team members who drive a Sunrise vehicle must sign the Driver job description and understand the key essential duties for safety and regulatory compliance ABOUT SUNRISE Ready to take the next step and make a bigger impact than you ever imagined? As part of our team, you will help brighten the future for everyone at Sunrise and beyond. That is why we make it a priority to celebrate the unique ways you bring moments of togetherness and joy to everyone you serve. And when combined with the support, benefits, and growth opportunities we offer, the result is a career that PositivelyShines with everything you need to reach your goals - at work and in your life. We also offer benefits and other compensation that include: Medical, Dental, Vision, Life, and Disability Plans Retirement Savings Plans Employee Assistant Program / Discount Program Paid time off (PTO), sick time, and holiday pay my FlexPay offered to get paid within hours of a shift Tuition Reimbursement In addition to base compensation, Sunrise may offer discretionary and/or non-discretionary bonuses. The eligibility to receive such a bonus will depend on the employee's position, plan/program offered by Sunrise at the time, and required performance pursuant to the plan/program. Some benefits have eligibility requirements Apply today to learn why Sunrise Senior Living is a certified Great Place to Work PRE-EMPLOYMENT REQUIREMENTS Sunrise considers the health and safety of its residents, family members, and team members to be one of its highest priorities. Employment with Sunrise is conditioned on completing and passing a drug test (which does not include marijuana), participating in testing requirements (e.g. Tuberculosis Test, Physical Evaluation). Covid-19 and Influenza vaccination is only required to the extent mandated by applicable federal, state, and local laws and authorities. COMPENSATION DISCLAIMER Selected candidates will be offered competitive compensation based on geographic location of community/office, skills, experience, qualifications, and certifications/licenses (where applicable).
    $44k-60k yearly est. Auto-Apply 60d+ ago
  • Staff Nurse

    QSL Management

    Utilization review nurse job in Baton Rouge, LA

    QSL Management is a fast-growing senior living company with ample opportunities for advancement. Our mission is to provide seniors with luxurious and comfortable resort-style homes while promoting wellness, security, longevity, family, joy, and self-worth. We believe in fostering an environment in which our team members can grow and thrive, and we are looking for leaders who exemplify our core values of Excellence, Compassion, Respect, Leadership, Integrity, Safety, & Joy. We are looking for team members who want to serve others. We offer a competitive wage and an excellent benefits package. Plus, we have a great work environment where you can make a difference in the lives of older adults. If this sounds like the opportunity that you have been looking for, please apply. We are currently looking for a Staff Nurse for The Barclay House of Baton Rouge Primary Responsibilities of the Staff Nurse: Provide medical treatment and administer medication according to physician orders within the scope of their applicable board and state regulations for assistant living. Provide world class care and service for our residents while remaining flexible and adapt to change. Assist residents with memory and performance improvement programs. Work independently (with minimal direct supervision) and with a team to make decisions, organize/prioritize tasks effectively, document clearly, and follow through on assignments. Serve as charge nurse on shift for the personal assistants under the direction of the Wellness Leadership team Requirements Must have a caring heart, willing to serve others. Current license for Licensed Practical Nurse (LPN) issued by the state. Current CPR certification Assisted Living or Long-term care experience preferred Current First Aid certification preferred Must be flexible and prepared to work a variety of shifts including weekends and holidays Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
    $45k-81k yearly est. 60d+ ago
  • Nurse Auditor 2

    Humana 4.8company rating

    Utilization review nurse job in Baton Rouge, LA

    **Become a part of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical documentation to ensure capture of all relevant coding. Applies clinical and coding experience to conduct a clinical validation review of the inpatient medical record to validate billed diagnoses. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. **Use your skills to make an impact** **WORK STYLE:** Remote/Work at Home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **WORK HOURS:** Typical business hours are Monday-Friday, 8 hours/day, 5 days/week. Associates are expected to start each day between 6AM and 9AM in their home time zone. **Required Qualifications** + Active Registered Nurse (RN) license in the state they reside. + Minimum of 2 consecutive years acute inpatient hospital care experience in critical, intensive care setting within the last 5 years (Not pediatrics or neonatal). For example: ICU, CCU, PCU, med-surg/adult units or a minimum of 2 years DRG Inpatient auditing. NOTE: Inpatient experience does **not** refer to any other levels of care such as ER, OR, Pre-op, PACU,L&D, mother-baby, behavioral health, SNF, care manager/discharge manager, LTC, rehab, outpatient or office/clinic visits such as wound care, oncology, radiology, interventional radiology, lab, hospice, or home health. + In depth knowledge and critical understanding of complex medical diagnoses including, but not limited to, Sepsis (including end-organ failure), Pneumonia, Acidosis, Renal Failure, Encephalopathy, CVA, DKA, MI, etc. + Advanced knowledge of MS Office (Word, Excel, etc) + Excellent writing, editing, interpersonal, planning, teamwork, and communications skills + Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information + Ability to work independently and manage workload + Customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession **Preferred Qualifications** + Bachelor's Degree in relevant field preferred + Inpatient coding certification (AHIMA or AAPC - ex: RHIA, RHIT, CCS, CIS, CIC) + Inpatient coding claim experience + Prospective payment methodologies, DRG auditing experience + Clinical documentation improvement knowledge (CDE, CDEI certification) **Additional Information** **Work at Home Requirements** - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested - Satellite, cellular and microwave connection can be used only if approved by leadership - Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Interview Format** As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $78,400 - $107,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $78.4k-107.8k yearly 60d+ ago
  • Nurse

    The Arc of East Ascension 3.5company rating

    Utilization review nurse job in Gonzales, LA

    Job Details Gonzales, LA $35.00 - $38.50 Description Registered Nurse Job Title: Registered Nurse Department: Administrative Reports To: Executive Director FLSA Status: Exempt Salary Grade: 113 Job Code: N/A Employee Status: Part-Time Work Schedule: 20-25 hours per week NATURE AND SCOPE OF POSITION The Registered Nurse will provide consultation and general nursing care to individuals in The Arc of East Ascension's programs. PRIMARY QUALIFICATIONS Education: Valid Louisiana RN License Certifications: CPR/First Aid certifications Current Louisiana driver's license Current Louisiana Register Nurse license Work Experience: Minimum 2 years experience providing support to individuals with developmental disabilities Special Skills: Moderate level of experience with Microsoft Office Suite applications with an emphasis on Word and Outlook Moderate level of experience navigating the internet AMERICANS WITH DISABILITY SPECIFICATIONS Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is occasionally required to stand, walk, sit, use hands to finger motions, stoop, kneel, crouch or crawl, talk or hear, taste or smell. The employee must occasionally lift and/or move up to 50 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to focus. Work Environment: Work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is exposed to weather and internal climate conditions prevalent at the time. The work environment is considered to be that of a normal business/office operation. The noise level in the work environment is usually moderate. ESSENTIAL DUTIES AND RESPONSIBILITIES Ensures quality health services are provided for individuals participating in all programs of The Arc of East Ascension, which includes but is not limited to assisting with pre-service screenings/visits and communicating with families and outside agencies. Administers prescribed medications and treatments in accordance with approved nursing techniques. Provides Medication Administration training to all Direct Support Staff across all programs. Determines if staff can be delegated to provide medication administration or administer state approved medical tasks. Attends meetings and trainings for all programs of The Arc of East Ascension as determined by the Executive Director. Conducts training and education on health-related topics for staff and individuals as needed or as requested regarding diagnosis, treatment, prevention of illness, and/or specific medical/nursing care needs. Oversees the health of all individuals; records significant conditions and reactions and notifies families, appropriate staff and/or appropriate physician of individual's condition and reaction to drugs, treatments, and significant incidents. Renders first aid and responds to emergency and/or lifesaving situations based upon nursing standards, policies, procedures, and protocol. Maintains and/or oversees current file on individuals regarding medical/health related information, including up-to-date immunizations and records on individuals treated while assuring confidentiality and compliance with HIPAA regulations. Ensures that all required/requested forms and reports for funding sources, support coordinators, external agencies, and internal departments are completed in a timely and accurate manner. Provides courteous and prompt service to all internal and external customers. Prioritizes and addresses requests and assignments in a professional manner to develop cooperative relationships and to ensure that customer confidentiality is assured. Identifies opportunities and recommends methods to improve service, work processes and financial performance, e.g. expense management. Assists in the implementation of quality improvement initiatives. Follows regulations based on Home and Community Based Waiver Services and Health Standards of the State of Louisiana Assists co-workers in the completion of tasks and assignments to ensure continuity of service. Actively supports teamwork throughout the organization. Complies with all policies stipulated in the employee handbook and all other policy and procedure guidelines. Performs other services as required. COMPETENCIES: To perform the job successfully, an individual should demonstrate the following competencies to perform the essential functions of this job. Functional Skills Job Skills - Possesses sufficient job skills and knowledge to perform the job in a competent manner. Is able to demonstrate skills and knowledge in day-to-day situations. This is distinctly different from those individuals who lack sufficient job skills or knowledge to meet job requirements or who have the skills and knowledge, yet struggle to apply them to day-to-day situations on the job. Managing Meetings - Runs efficient meetings that help achieve organizational goals. Plans for efficiency by only holding meetings that are clearly necessary, inviting the appropriate people, creating and communicating objectives and agendas and effectively leading participants through the items on the agenda. These contrasts with those who schedule unnecessary meetings, schedule meetings and then fail to invite the appropriate people, fail to create or communicate meeting objectives or agendas, and/or allow meetings to become unproductive by failing to manage a process that moves people through the agenda in an efficient and productive manner. Writing Skills - Produces clear and complete written reports that meet the needs of the customer. Written reports use words and tone that are appropriate for the intended audience and are produced and distributed in a timely manner. This differs from reports that use jargon or other words that may not be understood by the intended audience, reflect an inappropriate tone and/or are distributed too late to meet the needs and expectations of various stakeholders. Planning - Develops the steps necessary to accomplish long-term goals. Identifies long and short-term goals and establishes realistic plans to reach them. Allocates required resources, allows for contingencies and ensures that plans fit with the larger needs of the organization. Sets milestones to measure progress along the way. This is distinctly different from individuals who ignore long-term or short-term goals, fail to link their goals to broader initiatives, have not set realistic plans that allow for contingencies, and/or ignore the importance of milestones that could enhance motivation in the pursuit of long-term plans. Technical Skills - Possesses the technical skills and knowledge required to perform essential tasks in an efficient and effective manner. Demonstrates the willingness and ability to train or coach others in the technical arena. This is quite different than those individuals who lack technical skills or knowledge and/or have failed to demonstrate a willingness and ability to train others to perform well in technical assignments Operating Skills Communication - Communicates effectively and appropriately. Uses good judgment as to what to communicate to whom as well as the best way to get that accomplished. Speaks in a clear and credible manner, selecting the right tone for the situation and audience. Listens to others and allows them to make their point. This is quite different than those who tend to select the wrong means of communicating, or who communicates information to inappropriate people. It also contrasts with those whose messages are not clear or lack credibility, as well as those who demonstrate poor listening skills and are unreceptive to feedback. Decisiveness - Investigates all viable options, along with the potential consequences of each, and then makes timely decisions. Can direct a group through this process and does not hesitate to make difficult decisions. Can speed up the decision-making process when time is of the essence, yet can also slow it down when there is time to do so. This differs from those who make quick decisions even when there is little time pressure or too few options have been explored, who struggle to make decisions when they are difficult or controversial, who fail to take charge when a group is struggling to move forward; and/or who miss "windows of opportunity" by delaying decisions when timing is truly a critical factor. Managing Multiple Priorities - Handles multiple assignments and priorities yet still fulfills all commitments. Readily accepts new responsibilities and adapts well to changes in procedures. Gives appropriate priorities to various work demands. This is quite different from those who struggle to stay focused when faced with multiple priorities; focus only on one or two job priorities while neglecting others; and/or hesitate, complain or refuse to accept new procedures or assignments. People Management Encouraging Accountability - Ensures that employees understand their level of accountability, including what they are responsible to deliver and are expected to undertake. Employees are confident about how much support they will receive when they accept ownership of projects and issues. This is in contrast to those individuals who leave too much room for interpretation when it comes to expectations and accountability, or who leave those who commit to do assignments feeling unsupported or abandoned when they encounter obstacles or need answers to questions that arise in the course of a project or task. Personal Attribute Dependability - Makes and fulfills commitments. Has established a pattern of working independently, meeting reasonable deadlines, and accepting responsibility for his or her actions. Willingly makes promises and fully intends to keep them. Arrives at work on time and ready to contribute. Shows up for meetings well-prepared. This contrasts with individuals who have proven to be unreliable when others have counted on them to show up on time, meet deadlines and expectations, or arrive prepared and ready to contribute. Flexibility - Adjusts quickly and effectively to changing conditions and demands. Discusses change as a necessary and inevitable aspect of organization life as well as an opportunity to learn new things. Has a similar view and approach to potentially stressful situations. Invests personal energy toward accepting and adapting to changes that others use toward resisting or resenting it. This is in contrast to those who tend to react too negatively about change and whose productivity and relationships with others suffer as a result. Those who fail to demonstrate flexibility tend to continue in a direction that is no longer relevant or productive, express regrets when things are not as they used to be and show distinct signs of stress while others are already swimming in the direction of the tide. Work Ethic - Is keenly aware of the time frame in which tasks or projects need to be done. Accepts and mirrors the level of urgency conveyed by manager or customer being served. Puts first priority on the needs of the organization or the needs of its customers. This contrasts with the behavior of individuals who lose sight of approaching deadlines, fail to fully accept ownerships for commitments that have been made to others, and/or make decisions and spend time in self-serving ways that fail to place proper emphasis on organizational or customer needs.
    $47k-61k yearly est. 46d ago
  • Nurse Auditor Lpnlvn

    Priority Management 3.1company rating

    Utilization review nurse job in Lutcher, LA

    Job Details Chateau St James Rehab and Retirement - LUTCHER, LA AnyNurse Auditor, LPN Nurse Auditor Come join an amazing team! Our care teams are true caregivers. They serve patients with dedication and compassion and are the heart of our patients' care and recovery. Whether providing direct care or operational support, Priority Management seeks people who share our commitment to providing excellent care to our patients and residents. Our patients are our passion and we invite you to join our team! Job Summary: The Nurse Auditor maintains the policies and procedures established for the record keeping of the nursing facility to comply with all regulations, both State, Federal and Health Information Management Standards. Performance Requirements: The Nurse Auditor is responsible for assembling, performing the concurrent reviews as outlined by company policy, storing and protecting the clinical records and maintaining an organized record system for both active and discharged files for prompt retrieval. Job Duties - Outlined: Legal Aspects: Knowledgeable about release of information according to State and Federal Guidelines. Prepares reports for court. Destroys clinical records according to company policy. Control of Clinical Record Files: Maintains filing system in an organized manner for both active and discharged records. Maintains a number system for record identification. Completion of Discharges/Transfers/Death Records Special Duties: Consists of Analysis and Evaluation of Clinical Records Benefits Include: Medical Dental Vision Basic Company Paid Life insurance Long Term Disability Voluntary Life Insurance for the Employee, Employee Spouse and Employee Children Short Term Disability, Cancer, Critical Illness, Accidental and Universal Life Employee Referral Bonus Potential Program Daily Pay Tuition Reimbursement Paid Time Off Nurse Auditor Qualifications: The Nurse Auditor must have an active certified LPN license. Previous experience is helpful, but not required.
    $40k-60k yearly est. 60d+ ago
  • EMP. WELLNESS NURSE - HUMAN RESOURCES

    North Oaks Health System 4.2company rating

    Utilization review nurse job in Hammond, LA

    Status: Full Time Shift: Exempt, primarily days with rotating call Exempt: Yes Other information: Experience, Knowledge, and Skill 1. Previous Experience Required: Registered Nurse-current LA RN License, BSN or ADN with: 2 years RN experience OR 1 year RN experience and at least 3 yrs LPN experience OR 1 year RN experience and at least 5 years MA experience 2. Specialized or Technical Education Required: Knowledge of CDC guidelines, APIC practices and principles, adult immunization guidelines and the JCAHO standards as well as state and local public health regulations is preferred but not necessary. Familiarity with FMLA and ADA processes and DOT/NONDOT practices also helpful. 3. Manual or Physical Skill Required: Physical requirements are minimal. Knowledge of computer is required. Must be able to accurately use all required software programs. 4. Physical Effort Required: Strength: Light Push: Occasionally Pull: Occasionally Carry: Occasionally Lift: Occasionally Sit: Constantly Stand: Frequently Walk: Frequently Responsibilities: DESCRIPTION OF DUTIES: 1. Review and evaluate all health record documentation for hires and inform of additional information. 2. Perform all new hire physicals and drug screens following policy and procedure. 3. Perform QA activities as designated by Employee Wellness Manager. This includes trending infectious illnesses and report out monthly on trends. Must be able to track outbreaks and follow protocol/policy and work closely with ID doctor to maintain the health and wellness of exposed staff. 4. Assist with annual Tb Skin testing program, fit testing, annual flu vaccine program and other mandatory and elective immunizations. 5. Communicate with management health record information needs. 6. Maintain confidentiality of employee health information through telephone calls, correspondence, records, typed materials and other documents by observing all HIPPA guidelines for private medical information. 7. Participates in various committees and community programs. Serve as a representative of the Employee Wellness Department on hospital committees and task forces as assigned. 8. Prepare and submit monthly reports of current activities and projects. Maintain employee records and track/trend needed immunizations. 9. Performs office duties as assigned including office phone coverage, maintaining supplies, and ordering vaccinations. 10. Teaches educational classes as assigned such as General Orientation, N95 training, and supervisor training for BFI. 11. Attends departmental meetings as required. 12. Assist in reviewing and revising policies and procedures specific to Employee Wellness issues. 13. Responsible for complying with and enforcing all established and departmental policies and procedures. 14. Assists in planning and performing initial and annual N-95 fit testing on designated staff. Track and trend staff compliance. 15. Act as mental health liaison to encourage appropriate professional help during crisis and noncrisis situations. Direct to appropriate resources as needed. 16. Act as back up to ADA and FMLA processes to workman's comp liaison. 17. Follows North Oaks Health System's compliance programs and all federal and state regulatory guidelines. 18. Other duties as assigned by manager.
    $41k-60k yearly est. 38d ago
  • Treatment Nurse

    Gonzales Healthcare Center 4.2company rating

    Utilization review nurse job in Gonzales, LA

    Shift offered Monday-Friday management role 8am-4:30pm with on-call required Starting Rate:Rate will depend on experience and licensure INDNUR Nexion is a "Great Place to Work" because we provide: Free employee and family telehealth immediately upon hire Medical / Dental / Vision CareEarly PayFSA / HSA / 401k Educational Advancement / increased pay with competency levels Scholarship for employees and dependents Emergency Relief Requirements:RN/LVN/LPN license required Learn more about Nexion at ********************* EOE M/F/D/V
    $42k-55k yearly est. 59d ago
  • Treatment Nurse

    Nexion Health 3.6company rating

    Utilization review nurse job in Gonzales, LA

    Shift offered Monday-Friday management role 8am-4:30pm with on-call required Starting Rate: Rate will depend on experience and licensure INDNUR Nexion is a "Great Place to Work" because we provide: Free employee and family telehealth immediately upon hire Medical / Dental / Vision Care Early Pay FSA / HSA / 401k Educational Advancement / increased pay with competency levels Scholarship for employees and dependents Emergency Relief Requirements: RN/LVN/LPN license required Learn more about Nexion at ********************* EOE M/F/D/V
    $43k-52k yearly est. 16d ago
  • Travel Nurse Practitioner

    Monogram Health 3.7company rating

    Utilization review nurse job in Baton Rouge, LA

    Travel Nurse Practitioner Monogram Health is looking for a skilled Nurse Practitioner eager for the opportunity to make a difference in patients' lives. The Monogram Travel Nurse Practitioner plays a critical role in providing access to comprehensive care for underserved patients our Monogram Health network reach. Also, helping patients improve their quality of life in the home and slow the progression of kidney disease and multiple other chronic illnesses, enabling positive health outcomes. Your Impact: As a Travel Nurse Practitioner, you will be responsible for the delivery of personalized and compassionate care to patients primarily with CKD through ESRD. Monogram's Travel NPs will become nationwide float providers to the members in areas where our local clinicians are unable to reach and in areas where we are rapidly growing. Primary duties include patient health assessment, creating strategies to improve or manage a patient's health, and introducing habits for health promotion. In part of completing this care for patients, your responsibilities will include maintaining accurate patient records, scheduling, and administering follow-up appointments to patients as required across multiple markets. Highlights & Benefits Opportunity to work in a dynamic, fast-paced and innovative value-based provider organization that is transforming the delivery of kidney care Competitive salary Comprehensive medical, dental, vision and life insurance (1099 options also available) Flexible paid leave and vacation policy 401(k) plan with matching contributions Roles and Responsibilities Travels nationwide to conduct in-home assessments, which include comprehensive annual wellness exams, focused screenings, or other visits both in the patients' home and in the virtual environment Ability to travel out of town for up to 75% of the month during the work week Counsels and educates patients and families about benefits and programs available to help them live healthier lives Documents items such as: appropriate chief complaint, all applicable diagnosis, past medical, family, and social history, review of systems, examinations, medications, allergies, assessment, and plan Responsible for the coordination of care with primary care providers, specialists, and appropriate ancillary services Completes all documentation and paperwork in a timely manner Maintains quality of care standards as defined by the practice This position will not be office-based but will be based in state in which employed and will need to attend periodic training/meetings outside of that state Deliver evidence-based, timely care in a manner that reduces avoidable hospitalizations, maximizes quality of life, and puts patient health and satisfaction first Prescribe medications, order tests, and collaborate with patient's Monogram physician Perform effectively, as reflected by improved patient quality outcomes, which will be measured and reported daily Facilitates closing gaps in care by educating patients about preventive monitoring and working with physician practices to schedule diagnostic testing Assists patients with enrolling to access educational videos Participates in the integrated care team meetings Knowledge of disease diagnosis and prevention Make assessment of patient's health status Implement a plan consistent with appropriate plan of care Follow-up and evaluate patient's status Other duties as assigned Position Requirements Active and unrestricted Registered Nurse and Nurse Practitioner Board certified for appropriate licensure (NP: ANCC/AANP) Current and unrestricted DEA certificate, or eligibility Ability to travel extensively by air and utilize rental vehicles Ability to work without direct supervision and practice autonomously Access to transportation, a valid driver's license, and car insurance Must be proficient with medical instruments and equipment required by the work Knowledge of computer-based data management programs and information systems, as well as medical records and point-of-interview technology Ability to communicate effectively in verbal and written form with retail and medical partners at various levels, patients, family members, physicians and representatives of the community Sound understanding of all federal and state regulations including HIPAA and OSHA 2 or more years of direct patient care required About Monogram Health Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person's health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders. Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient's healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home. Monogram Health's personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum. #TNP
    $54k-105k yearly est. 60d+ ago
  • Aesthetic NP/PA Injector

    Diamond Accelerator

    Utilization review nurse job in Baton Rouge, LA

    Job Title: Aesthetic Injector -NP or PA Compensation: $65 per hour, Full-Time opportunity About Us At Coco Beauty Bar, we believe confidence is the ultimate beauty secret. Our boutique aesthetics practice in Baton Rouge is dedicated to providing safe, natural, and transformative results in a luxury, client-focused setting. We have an established patient base, but we are growing and looking for a Full-Time skilled Nurse Practitioner or Physician Assistant Injector to join our team! Why Join Us? Competitive pay at $65/hour Supportive, collaborative work environment Established patient base with room to grow Opportunities for continuing education and advanced training A culture built on professionalism, artistry, and exceptional patient care What You'll Do Perform injectable treatments including neurotoxins, dermal fillers, and other non-surgical procedures Conduct thorough consultations, listen to patient goals, and design personalized treatment plans Educate patients on treatments, pre- and post-care, and realistic expectations Deliver safe, consistent, and natural-looking results that build patient trust and loyalty Document treatments accurately and maintain compliance with clinical protocols Collaborate with our aesthetics team to elevate the patient experience What We're Looking For Licensed Nurse Practitioner (NP) or Physician Assistant (PA-C) in Louisiana 2+ years of injecting experience in aesthetics or cosmetic medicine (required) Strong knowledge of facial anatomy and advanced injection techniques Excellent communication and relationship-building skills Passion for aesthetics and dedication to continuous growth in the field ✨ If you're a skilled injector who thrives in a supportive, client-first environment and wants to grow with a forward-thinking practice, we'd love to hear from you! Apply today and help our patients look-and feel-their absolute best.
    $36k-60k yearly est. 60d+ ago
  • Appeals Nurse

    Humana 4.8company rating

    Utilization review nurse job in Baton Rouge, LA

    **Become a part of our caring community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Appeals Nurse 2 reviews documentation and interprets data obtained from clinical records to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and provider issues. Coordinates the clinical resolution with internal/external clinician support as required. Documents and summarizes to all parties involved in the case the investigation's results. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. **KEY ACCOUNTABILITIES** + Review medical documentation, obtain additional information that may be needed including timeframes when physician is available for peer to peer review, and forward to physician review companies or TQMC. Monitor and follow up for timeliness and review response and determination to insure follows TRICARE policy requirements. If discrepancies found will send back for follow up review and correction as needed. + Review, coordinate, arrange and maintain Second level Review /Reconsideration records and patient and provider response letters + Provide education to beneficiaries and providers regarding second level review time frames, process and review determinations. If needed provide education on alternatives for services that may be not be approved + Maintain knowledge of TRICARE, all HGB policies and procedures as well as medical necessity review criteria and privacy requirements **Use your skills to make an impact** **Required Qualifications** + Our Department of Defense contract requires U.S. Citizenship + Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing) + HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico. + Active unrestricted RN license + 3 years of clinical RN Experience + Appeals nursing experience + Claims experience + Proficient with Microsoft Office products including Word, Excel and Outlook **Preferred Qualifications** + Utilization Review/Quality Management experience + Experience working with MCG guidelines + Working knowledge of ICD-9 or ICD-10, HCPCS, DRG use + Experience with TRICARE contracts and/or the military health care delivery system + Knowledge of TRICARE policies and programs + Bachelor's degree **Additional Information** **Work Style** : Remote **Work Days/Hours:** Monday - Friday; 8:00 a.m.-5 p.m. Eastern Standard Time **Work at Home Requirements** To ensure Hybrid Office/Home associates' ability to work effectively, the self-provided internet service of Hybrid Office/Home associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested + Satellite, cellular and microwave connection can be used only if approved by leadership + Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $71.1k-97.8k yearly 3d ago
  • PRE-ADMIT TESTING (PAT) CHARGE NURSE - SAME DAY SURGERY

    North Oaks Health System 4.2company rating

    Utilization review nurse job in Hammond, LA

    Status: Full Time Shift: Monday through Friday, 0600-1630 x 4 days Exempt: No Responsible for the oversight of patient care for the department/unit assigned. Coordinates the clinical care of all patients located on the unit assigned. Ensures the cohesive delivery of services, patient satisfaction and safety. Supervises staff on nursing units in the absence of the Unit Director/Coordinator to assure that nursing standards and quality initiatives are met. Provides feedback to department leadership for performance improvement. Other information: A. Experience, Knowledge and Skill 1. 18 months of LPN experience with 6 months of RN experience and successful completion of preceptor course within 12 months OR 1 year of RN experience with successful completion of preceptor course within 12 months. 2 years of experience preferred. 2. Specialized or Technical Education Required: Graduate of an accredited school of nursing and possess current registration with the Louisiana State Board of Nursing. 3. Manual or Physical Skill Required: 4. Physical Effort Required: Strength: Medium Push: Occasionally Pull: Occasionally Carry: Occasionally Lift: Occasionally Sit: Occasionally Stand: Frequently Walk: Frequently Responsibilities: DESCRIPTION OF DUTIES: 1. Validates staffing needs with the Nurse Manager or Perioperative Director based on the unit's staffing plan and patient care needs. o When identifying staffing needs, takes into consideration patient needs and acuity, admits and discharges, staff competency, FAN or agency assigned, and staff in orientation. o Completes patient assignments each shift based on acuity and staff skills. o Assessallreportedchangesinstatusforappropriatenessofassignmentandplacement. o Assess the care of the patients assigned to an LPN. Delegates care to a Registered Nurse as needed. o Monitors staff competency and patient acuity to ensure patient safety. Notifies management team of concerns. 2. Monitors and maintains efficient patient flow. o Collaborates with Administrative Nursing Supervisor/Bed Control for proper patient placement (Staff Competency and Patient Acuity used as factors) o Communicates patient discharge planning needs with department case manager, social worker, and other disciplines as appropriate. o Facilitates timely patient admissions, discharges, and transfers. 3. Patient Care/Experience. o Rounds on patients to ensure satisfaction of patient experience. Provides immediate service recovery for noted issues. Communicates concerns to management team. o Supports and maintains compliance with hourly rounding expectations for care team. o Monitors team for compliance with service delivery initiatives. 4. Department Operations. Clinical/service: o Monitors desk for new patient orders and timely transcription/processing. o Monitors new orders for safety concerns (unapproved abbreviations and "blanket orders") and works with Pharmacy and Medical Staff to clarify. o Ensures safe work environment - frequently communicates with staff and others to address concerns as they occur. o Ensures compliance for performance and documentation with core measures, prevention of hospital acquired conditions/infections (falls, CAUTIs, CLABSIs), pre/post-op processes, restraint utilization, critical values, changes in patient condition, medication reconciliation, PEC/CEC patients, and isolation compliance. o Welcomes float/agency staff and ensures they are comfortable with department, patient assignment and equipment use. Provides immediate education and competency validation as needed. o Documents all care delivered and reassessments completed. Documents follow-up to any concerns from a patient. o Screens outgoing call to physicians for appropriateness and staff readiness to respond to incoming returned phone calls. o Monitors for timely completion of consultations, both medical staff and ancillary support services consults. o Aware of physicians rounding for appropriate privileges and record access o Monitors staff compliance with Patient Services, Department and Administrative Policies/Procedures and Programs. Provides immediate/confidential corrective action and competency demonstration and communicates concerns to management team. o New employees - ongoing monitoring of progression, feedback to Coordinator/Director, and evaluation input. Ensures orientation experience is met as planned and meets expectations of new staff. o Validatesphysicianshaveprivilegespriortopatientrecordaccess.Verifyphysicianspecialprocedureprivilegepriortophysicianperforming invasive procedure. Operational: o Monitors meal periods and breaks to ensure adequate staffing at all times. o Monitors staff productivity. Adjusts staffing as patient volume changes. o Monitors general housekeeping/appearance of department. Contacts Environmental Services (EVS) as needed. Keeps hallways clear. o Assures storage and security of equipment. Reports equipment errors/repairs timely and correctly. o Maintains supply inventory, charging and resolution of lost charges daily. o Ensures disaster box complete with all necessary forms. o Completes Press Ganey HRP report for all unexpected patient outcomes, unresolved patient/family complaints, unresolved physician/ancillary complaints with all known information at the time. o Notifies Administrative Nursing Supervisor for all staff injuries. Notifies Security for visitor injuries. o Immediately notifies management with beginning investigative findings and follow-up on all pertinent data relating to above unexpected events. o Leadership: o Keeps the Unit Coordinator/Director informed of staff, patient, and physician issues. o Promotes positive relationships with unit staff and ancillary departments providing service to the department o Promotes satisfactory relationships among the unit staff, other departments, the medical staff, and external agencies (ie. Ambulance services, law enforcement, etc). o Maintains confidentiality o Channels suggestions, criticism, and questions to Coordinator/Director. o Assists leadership with enforcement of professional behavioral standards and job role responsibilities for care delivery team. o Assists in maintaining ongoing preparedness for inspections/surveys. o Provides input to employee evaluations. o Assists with identification of learning needs for all staff. o Maintains a positive attitude and promotes compliance with organizational and department goals at all times. Assists with assignments as delegated by Department Management Team.
    $26k-58k yearly est. 60d+ ago

Learn more about utilization review nurse jobs

How much does a utilization review nurse earn in Baton Rouge, LA?

The average utilization review nurse in Baton Rouge, LA earns between $42,000 and $76,000 annually. This compares to the national average utilization review nurse range of $47,000 to $89,000.

Average utilization review nurse salary in Baton Rouge, LA

$57,000

What are the biggest employers of Utilization Review Nurses in Baton Rouge, LA?

The biggest employers of Utilization Review Nurses in Baton Rouge, LA are:
  1. Centerwell
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