RN Care Coordinator / Utilization Review Nurse

American Case Management Association, Inc.; New Orleans (LA); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

None

Job summary

Ochsner Health is seeking an RN Care Coordinator / Utilization Review Nurse to coordinate patient care across hospitalization, discharge planning, and care transitions.

You will perform admission, continued-stay, and utilization reviews, collaborate with physicians and care teams, and advocate for optimal patient outcomes. Strong knowledge of CMS guidelines and regulatory requirements is essential. This role supports efficient, patient-centered care in a multidisciplinary environment.

Qualifications

• Graduate of an accredited School of Nursing.
• Current Registered Nurse (RN) license in the state of practice.
• Basic Life Support (BLS) certification through the American Heart Association.
• Preferred: Bachelor’s Degree in Nursing (BSN).
• Experience in case management, discharge planning, utilization review, or care coordination is a plus.

Responsibilities

• Conduct admission, continued-stay, and utilization reviews using CMS, payer, and organizational guidelines.
• Collaborate with physicians and care teams to ensure appropriate level-of-care determinations and documentation.
• Coordinate individualized discharge planning and transitions of care.
• Serve as a liaison among patients, families, providers, payers, and post-acute care partners.
• Help optimize patient outcomes, resource utilization, and overall care experience.
• Maintain knowledge of regulatory requirements related to utilization management and discharge planning.
• Promote exceptional patient-centered care and service excellence.

Skills

CMS guidelines

Utilization review

Discharge planning

Care coordination

Interdisciplinary collaboration

Patient advocacy

Documentation

Education

RN license

BLS certification

BSN (preferred)

Job description

RN Care Coordinator / Utilization Review Nurse

Make a Lasting Difference in Patient Care

At Ochsner Health, every team member plays an important role in delivering exceptional care. Since 1942, we have been driven by a mission to serve, heal, lead, educate, and innovate. Today, that mission continues through the dedicated professionals who support patients and families at every stage of their healthcare journey.

If you're a Registered Nurse who enjoys collaboration, problem-solving, patient advocacy, and helping patients achieve the best possible outcomes, we invite you to explore this opportunity.

Why Join Ochsner Health?

As a Care Coordinator, you'll be a trusted advocate for patients, helping them navigate complex healthcare needs while working alongside physicians, nurses, case managers, and interdisciplinary teams. Your expertise will directly influence patient outcomes, care transitions, and the overall healthcare experience.

In this role, you'll have the opportunity to:

• Advocate for patients and their families throughout hospitalization
• Collaborate with physicians and multidisciplinary care teams
• Coordinate safe, efficient, and patient-centered discharge plans
• Help ensure patients receive the appropriate level of care and services
• Build expertise in utilization review, care coordination, and case management

Position Summary

The RN Care Coordinator serves as a key member of the healthcare team, coordinating care throughout a patient's hospital stay. This role combines clinical expertise, resource management, patient advocacy, and interdisciplinary collaboration to ensure patients receive the right care at the right time and in the most appropriate setting.

You will work closely with patients, caregivers, physicians, and community resources to support quality outcomes, efficient care delivery, and successful transitions of care.

What You'll Do

• Conduct admission, continued-stay, and utilization reviews using CMS, payer, and organizational guidelines
• Collaborate with physicians and care teams to ensure appropriate level-of-care determinations and documentation
• Coordinate individualized discharge planning and transitions of care
• Serve as a liaison among patients, families, providers, payers, and post-acute care partners
• Help optimize patient outcomes, resource utilization, and overall care experience
• Maintain knowledge of regulatory requirements related to utilization management and discharge planning
• Promote exceptional patient-centered care and service excellence

Qualifications

Required

• Graduate of an accredited School of Nursing
• Current Registered Nurse (RN) license in the state of practice
• Basic Life Support (BLS) certification through the American Heart Association

Preferred

• Bachelor's Degree in Nursing (BSN)
• Experience in case management, discharge planning, utilization review, or care coordination
• Certification in Case Management (CCM) or Accredited Case Manager (ACM)

What Makes You Successful

We're looking for nurses who are:

• Passionate about patient advocacy and care coordination
• Strong communicators and relationship builders
• Organized and detail-oriented
• Comfortable navigating complex healthcare systems
• Collaborative team players who thrive in multidisciplinary environments
• Adaptable and committed to continuous learning and professional development

Build Your Future at Ochsner

Whether you are looking to expand your clinical impact beyond bedside care or develop expertise in care management and utilization review, this role offers meaningful work, professional growth, and the opportunity to improve the lives of patients every day.

Join a team where your clinical knowledge, compassion, and leadership make a difference.