Top 34 Of utilization management Jobs in Monroe La

Utilization Review/Case Manager
Freedom Behavioral Hospital of Monroe —West Monroe, LA
- $18 - $22 an hour
- Full-time
- Mid-level
- Time management
- Health insurance
- Dental insurance
Quick Apply
2d
Program Manager
Sea Mar Community Health Centers —Monroe, LA
- $90,000 a year
- Full-time
- Mid-level
- Outpatient experience
- Master's degree
- Paid holidays
- Disability insurance
Director Case Management
Glenwood Regional Medical Center —West Monroe, LA
- Full-time
- Nursing
- RN License
- Hospital
Quick Apply
Assistant Director of Nurses (ADON)
Freedom Behavioral Hospital of Monroe —Monroe, LA
- $84,000 - $95,000 a year
- Full-time
- Nursing
- Current TB test
- RN License
- Health insurance
- Dental insurance
Quick Apply
13d
MDS Coordinator
AVALON PLACE LP —Monroe, LA
- Full-time
- Nursing
- Skilled nursing facility
- RN License
- Flexible schedule
Quick Apply
RN Case Manager
Glenwood Regional Medical Center —West Monroe, LA
- Full-time
- Acute care
- Nursing
- Mid-level
Quick Apply
Wellness Director-GOS
Gardens of Somerset —Monroe, LA
- Full-time
- Nursing
- RN License
- Residential
Quick Apply
Medical Field Case Manager
Enlyte —Monroe, LA
- $70,000 - $75,000 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Health savings account
QUALITY DIRECTOR
Freedom Behavioral Hospital of Bastrop —Bastrop, LA
- $30 - $34 an hour
- Full-time
- Clinic experience
- Analysis skills
- Computer skills
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Nurse Manager
Freedom Behavioral Hospital of Monroe —West Monroe, LA
- $85,000 - $95,000 a year
- Full-time
- Acute care
- Nursing
- RN License
- 401(k)
- Vision insurance
Quick Apply
13d
Psychiatric-Mental Health Nurse Practitioner (PMHNP-BC)
LDH-Northeast Delta Human Services Authority —Monroe, LA
- Contract
- Nursing
- Psychiatry
- RN License
Case Manager - RN
Franciscan Missionaries of Our Lady Health System —Monroe, LA
- Day shift
- Acute care
- Nursing
- RN License
Registered Nurse - RN
Optum —West Monroe, LA
- $64,132 - $96,198 a year
- Full-time
- CPR Certification
- RN License
- Writing skills
Quick Apply
Registered Nurse - RN (Home Health)
Optum —Monroe, LA
- $55.50 an hour
- Full-time
- CPR Certification
- RN License
- Writing skills
Quick Apply
Psychiatrist
LDH-Northeast Delta Human Services Authority —Monroe, LA
- Part-time
- Medicine
- Psychiatry
- BC/BE
Certified Occupational Therapy Assistant (COTA) - PRN
Lagniappe Rehabilitation Services —West Monroe, LA
- Weekends as needed
- Management
- Writing skills
- Mid-level
Quick Apply
Nuclear Medicine Technologist PRN Premium
Franciscan Missionaries of Our Lady Health System —Monroe, LA
- PRN
- Mid-level
- Pediatrics
- Organizational skills
Pharmacist PRN Premium (Retail)
Franciscan Missionaries of Our Lady Health System —Monroe, LA
- PRN
- BLS Certification
- Mid-level
- Bachelor's degree
Quick Apply
Remote Physician (MD/DO), PMR or Neurology, Outpatient Prior Authorizations (REMOTE/FT) (IC to FTE)
Virtix Health —United States
- $125 an hour
- 8 hour shift
- Remote
- Background check
- Medicine
- Doctoral degree
- Work from home
Quick Apply
Family Medicine Medical Director Utilization Management
Amerihealth Caritas —United States
- Weekends as needed
- Hybrid work
- Medicine
- Physical & Rehabilitation Medicine
- 3 years
- Paid holidays
- Health insurance

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of utilization management jobs near monroe la

Utilization Review/Case Manager

Freedom Behavioral Hospital of Monroe -
West Monroe, LA

Quick Apply

Job Details

Full-time
$18 - $22 an hour
2 days ago

Benefits

Health insurance
Dental insurance
401(k)
Vision insurance

Qualifications

Collaborate with healthcare professionals
TJC
Patient resource coordination
Process optimization
Maintaining patient confidentiality
Regulatory compliance
Client rights in caregiving
Care documentation
Quality management
Mid-level
Transitional care planning in clinical case management
Overseeing care coordination
Pre-authorization review for utilization management
Utilization management
Care coordination meetings experience
Continuous clinical improvement initiatives
Resource utilization in healthcare
Multidisciplinary team collaboration for treatment planning
Concurrent review in utilization management
Data collection
Healthcare data collection
Managing patients as a clinical case manager
Interdisciplinary behavioral health coordination experience
Provider communication in social service case management
Time management

Full Job Description

The Utilization Review/Case Manager is responsible for coordinating patient care services and managing utilization review functions to ensure appropriate level of care, timely insurance authorization, and effective discharge planning. This role serves as the primary liaison between the hospital, payor sources, patients, families, and referral partners to support optimal clinical and financial outcomes.

In accordance with The Joint Commission standards, federal and state regulations, and Freedom’s mission, policies, and Performance Improvement (PI) program, the Case Manager facilitates the continuum of care from admission through discharge.

Key Responsibilities:

Coordinates with Admissions and Clinical staff to ensure patient treatment needs are identified and met throughout the stay
Conducts utilization review activities, including securing initial and continued stay authorizations from insurance providers
Serves as the primary point of contact with payors, communicating medical necessity, level of care, and continued stay criteria
Develops, implements, and manages discharge plans to ensure safe and appropriate transitions of care
Communicates effectively with patients, families, and referral sources to support positive treatment outcomes
Gathers and presents clinical information to the multidisciplinary treatment team; actively participates in treatment team meetings
Maintains consistent communication with physicians, nursing, social services, and other disciplines to ensure coordinated care delivery
Documents all utilization review and discharge planning activities accurately and timely in the medical record, supporting intensity of service and medical necessity
Collaborates with external agencies and providers to coordinate aftercare services and continuity of care
Ensures patient rights, ethical standards, and confidentiality are upheld at all times
Participates in Performance Improvement (PI) and Quality Management (QM) activities, including data collection and process improvement initiatives

Qualifications & Skills:

Strong understanding of behavioral health levels of care, medical necessity criteria, and insurance authorization processes
Ability to effectively communicate with multidisciplinary teams, payors, patients, and families in a professional manner
Excellent organizational, documentation, and time management skills
Knowledge of regulatory and accreditation standards related to case management and utilization review
Ability to manage multiple priorities while maintaining accuracy and compliance

Excellent Benefit Package Offered for Full-Time Employees:

Medical

Dental

Vision

401k

Life and Disability

Freedom Behavioral Hospital of Monroe provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

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Refine Your Search

of utilization management jobs in monroe la

Utilization Review/Case Manager

Program Manager

Director Case Management

Assistant Director of Nurses (ADON)

MDS Coordinator

RN Case Manager

Wellness Director-GOS

Medical Field Case Manager

QUALITY DIRECTOR

Nurse Manager

Psychiatric-Mental Health Nurse Practitioner (PMHNP-BC)

Case Manager - RN

Registered Nurse - RN

Registered Nurse - RN (Home Health)

Psychiatrist

Certified Occupational Therapy Assistant (COTA) - PRN

Nuclear Medicine Technologist PRN Premium

Pharmacist PRN Premium (Retail)

Remote Physician (MD/DO), PMR or Neurology, Outpatient Prior Authorizations (REMOTE/FT) (IC to FTE)

Family Medicine Medical Director Utilization Management

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