Utilization Review Jobs in New Orleans
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Search Results - Utilization Review Jobs in New Orleans
Gainwell-New Orleans
and technical development academies
Responsibilities
• Provide clinical guidance on policies, drug utilization, and pharmacy operations
• Perform clinical evaluations of medication therapy including prior authorization reviews and DURs
• Conduct peer-to-peer...
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Concentra, Inc.-New Orleans
hold a Louisiana MD license and be in active medical practice, with strong credentialing and utilization review expertise to support quality care and regulatory compliance.
#J-18808-Ljbffr...
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appcast.io -
UnitedHealth Group-New Orleans
management field
• 6+ years of experience in utilization, review/management, case management, and care management
• 4+ years of experience in adult education/training including presenting materials
• Experience in healthcare hospitals and payer-based software...
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4062 Aetna Resources, LLC-New Orleans
Standard Time (CST), with flexibility for occasional weekends and holidays
Preferred Qualifications
• Louisiana residency strongly preferred
• Managed Care, Utilization Review, or Utilization Management experience
• Behavioral health inpatient experience...
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UnitedHealth Group-New Orleans
or Marriage and Family Counseling or Licensed Ph.D. level Psychologist (independently licensed)
• Board certification as a Behavior Analyst (BCBA) and state licensure as required
• 3+ years of Managed Care and/or Utilization Review experience
• 3+ years...
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4004 Aetna Medicaid Administrators-New Orleans
CCM) certification.
• Master's degree in a healthcare, social services, or related field.
• Crisis intervention experience and skills.
• Utilization review experience.
• Case management and discharge planning experience.
• Experience with QuickBase...
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Aspire365-New Orleans
in accordance with organizational policy and regulatory standards.
• Prepare documentation needed for utilization review, audits, and insurance authorization
Qualifications:
• LCSW, LMFT, LPC, LMHC or similar (Required)
• Independent Licensure is required...
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New Orleans
procedures, and performance standards and URAAC guidelines and state regulations. Candidate must have an LA MD license.
Responsibilities:
MAJOR DUTIES AND RESPONSIBILITIES: Reviews medical files and provides recommendations for utilization review, chart...
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icims.com -
Cummins-New Orleans
generation applications
• Lead project planning sessions with internal stakeholders to define scope, objectives, milestones, and performance goals
• Develop cross-functional schedules and resource plans to meet timelines and optimize utilization
• Review...
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New Orleans
Responsibilities:
MAJOR DUTIES AND RESPONSIBILITIES:
• Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and Medical...
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icims.com -
New Orleans
Review policies, procedures, and performance standards and URAAC guidelines and state regulations
Responsibilities:
MAJOR DUTIES AND RESPONSIBILITIES: Reviews medical files and provides recommendations for utilization review, chart reviews, medical...
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icims.com -
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