Impactful Population Health RN — Case Management

Bcbsla; Louisiana; On-site; USD 70,000 - 90,000; Full time

Job summary

Louisiana Blue is seeking a Registered Nurse for care coordination and case management to support high-risk members. The role focuses on organizing, assessing, planning, and delivering care aligned with physician plans and evidence-based guidelines.

The nurse will collaborate with physicians, payors, and community resources to improve health outcomes and cost efficiency, while ensuring compliance with regulations and accreditation standards.

Qualifications

• Diploma in nursing or Associate’s in nursing or Bachelor’s in nursing required.
• 3 years of recent direct patient care/clinical experience is required.
• 2 years of experience in managed care is preferred.
• Experience in behavioral interviewing techniques and theory is preferred.

Responsibilities

• Assess member status and develop a comprehensive case management plan.
• Determine objectives and actions with time-specific indicators; advocate for member/family while maintaining privacy and safety.
• Implement a comprehensive case management plan.
• Coordinate resources to achieve goals across continuum of care.
• Collaborate with providers, payors, employers, and community resources to organize care.
• Conduct case conferences and evaluate plan effectiveness.

Skills

Prioritize & multitask

Independent work

Plan & evaluate services

Research & analyze contracts

Medical terminology

Excellent interpersonal skills

Strong communication (claims info)

Telephonic skills

Education

Nursing degree (Diploma/ASN/Bachelor)

Tools

Care management software

Job description

Louisiana Blue is seeking a Registered Nurse for care coordination and case management to support high-risk members. The role focuses on organizing, assessing, planning, and delivering care aligned with physician plans and evidence-based guidelines.

The nurse will collaborate with physicians, payors, and community resources to improve health outcomes and cost efficiency, while ensuring compliance with regulations and accreditation standards.