Telephonic Case Manager – Medicare/Medicaid, LA

Louisiana Blue; Monroe (LA); On-site; USD 70,000 - 90,000; Full time

Job summary

Louisiana Blue is seeking a Case Management Nurse to provide telephonic case management for members enrolled in Medicare and Medicaid, aligning with CMS standards and BCBSLA policies. You will assess member needs, coordinate with care teams, and develop individualized care plans, guiding members and families to appropriate resources while collaborating with clinicians and the interdisciplinary team.

Residency in Louisiana preferred; LPN licensure required; strong communication and

Qualifications

• High School Diploma required.
• LPN licensure in Louisiana required.
• Compact license or ability to obtain within 90 days.

Responsibilities

• Actively participates in enrollment activities and care coordination.
• Performs telephonic case management and coordinates with the interdisciplinary team.
• Evaluates cases for referrals to social services and community resources.
• Collects clinical information and documents findings in Acuity system.
• Develops individualized care plans with member/family and ICT.
• Ensures ongoing evaluation of progress and adjust plans accordingly.

Skills

Interpersonal skills

Documentation

Problem solving

Independent work

Accountability

Trust building

Customer focus

Results oriented

Quality monitoring

Education

High School Diploma

LPN license

Compact license

Job description

Louisiana Blue is seeking a Case Management Nurse to provide telephonic case management for members enrolled in Medicare and Medicaid, aligning with CMS standards and BCBSLA policies. You will assess member needs, coordinate with care teams, and develop individualized care plans, guiding members and families to appropriate resources while collaborating with clinicians and the interdisciplinary team.

Residency in Louisiana preferred; LPN licensure required; strong communication and