REGISTERED NURSE-PROGRAM COORDINATOR

State of Louisiana; Baton Rouge (LA); On-site; USD 70,000 - 98,000; Full time

Job summary

Louisiana Works is seeking a Registered Nurse-Program Coordinator in Baton Rouge to oversee medical services and MTG dispute resolution within the OWCA framework.

The role requires RN licensure with 3+ years of experience (or equivalent combinations) and knowledge of medical terminology, regulatory compliance, and claims review. Collaboration with providers and state agencies is essential; drug screening and background check are required.

Qualifications

• Must be a licensed registered nurse with relevant clinical experience.
• Experience with workers’ compensation or medical claims review is a plus.

Responsibilities

• Analyze and review all claims, medical records, and documentation to evaluate the necessity, appropriateness, and level of medical services provided.
• Contact and confer with providers, carriers, and other entities to obtain additional documentation such as progress reports, operative reports, and procedure codes.
• Maintain and update case files, closing them in accordance with departmental policy.
• Review and process Medical Treatment Guideline (MTG) requests, coordinating with the Medical Director to ensure timely issuance of determinations.
• Coordinate with stakeholders on matters involving medical services or disputes related to the reimbursement schedule

Skills

Nursing practice

Medical terminology

Regulatory compliance

Communication

Education

Bachelor's degree in nursing + 2 years RN exp

Master's degree in nursing or public health + 2 years RN exp

Doctorate in nursing or public health + 1 year RN exp

Three years experience as licensed RN

Job description

About This Job

Office of Workers’ Compensation

Division: Medical Services

Location: East Baton Rouge Parish

Louisiana Works transforms lives and drives prosperity by putting people at the center of everything we do. We provide one seamless door where individualized solutions create new possibilities, proving that when government works for people, Louisiana works for everyone.

Learn more about Louisiana Works

Registered Nurse-Program Coordinator

The RN Program Coordinator will display comprehensive knowledge of nursing practices, medical terminology, and applicable laws and regulations governing workers’ compensation claims. In addition, the RN Program Coordinator will manage medical treatment guideline disputes submitted to the OWCA.

The Office of Workers’ Compensation Administration (OWCA) in Louisiana oversees the enforcement and administration of workers’ compensation laws, aiming to support early return-to-work efforts and improve workplace safety. The department manages disputed claims, conducts hearings, reviews medical treatment disputes, and investigates fraud through collaborative efforts like the GAME ON task force.

Minimum Qualifications

• Three years of experience as a licensed registered nurse; OR
• A bachelor's degree in nursing plus two years of experience as a licensed registered nurse; OR
• A master's degree in nursing or public health plus two years of experience as a licensed registered nurse; OR
• A doctorate in nursing or public health plus one year of experience as a licensed registered nurse.

Job Specification

The official job specifications for this role, as defined by the State Civil Service, can be found here.

Job Duties And Other Information

Job Details

• Analyze and review all claims, medical records, and documentation to evaluate the necessity, appropriateness, and level of medical services provided.
• Contact and confer with providers, carriers, and other entities to obtain additional documentation such as progress reports, operative reports, and procedure codes.
• Maintain and update case files, closing them in accordance with departmental policy.
• Review and process Medical Treatment Guideline (MTG) requests, coordinating with the Medical Director to ensure timely issuance of determinations.
• Coordinate with stakeholders on matters involving medical services or disputes related to the reimbursement schedule

Position Specific Details

Location: Baton Rouge, La

Appointment Type: Probational / Job Appointment / Promotional / Detail to Special Duty

All applicants selected for employment must submit to drug screening and a background check.

Contact Information

For further information about this vacancy, contact:

Kedrick Kennedy

[e-mail]

• TDD# 800-259-5154.

Louisiana Works is an equal employment opportunity employer and SAME agency that serves as a model employer for the recruitment, hiring, and retention of individuals with disabilities.

Auxiliary aids and services are available upon request to individuals with disabilities

Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity to make a difference through public service. With an array of career opportunities in every major metropolitan center and in many rural areas, state employment provides an outstanding option to begin or continue your career.

As a State Employee, You Will Earn Competitive Pay, Choose From a Variety Of Benefits, And Have Access To a Great Professional Development Program

Insurance Coverage More information can be found at https://info.groupbenefits.org/

Parental Leave - Up to six weeks paid parental leave

More information can be found at https://www.civilservice.louisiana.gov/Parental-Leave/Default.aspx

Holidays and Leave

• New Year's Day
• Martin Luther King, Jr. Day,
• Mardi Gras,
• Good Friday,
• Memorial Day,
• Independence Day,
• Labor Day,
• Veteran's Day,
• Thanksgiving Day and Christmas Day.

Additional holidays may be proclaimed by the Governor

State employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.

Retirement

State Of Louisiana Employees Are Eligible To Participate In Various Retirement Systems (based On The Type Of Appointment And Agency For Which An Employee Works). These Retirement Systems Provide Retirement Allowances And Other Benefits For State Officers And Employees And Their Beneficiaries. State Retirement Systems May Include (but Are Not Limited To):

• Louisiana State Employees Retirement System (www.lasersonline.org). LASERS has provided this video to give you more detailed information about their system
• Teacher's Retirement System of Louisiana (www.trsl.org),
• Louisiana School Employees Retirement System (www.lsers.net), among others