Care Coordination Nurse I
Louisiana Blue · United States · US
Utilization Review
Remote
Nurse
Pharmacist
Demand68
Career growth58
Healthcare fit68
Remote potential45
5-year outlook
Payer-side utilization review and care coordination roles typically offer stable, moderate compensation aligned with LPN-level clinical backgrounds, with incremental growth tied to certification (CPUR/CPC/CMCN) and progression into senior review or management positions. Exact figures vary by market and should be verified locally.
Clinical license
Required
Applicant reach
moderate
Seniority
junior
Employment type
full-time
Date found
2026-10-06
Intelligence details
Flexible work details
- Side income
- Classified as side-income friendly
- Engagement type
- Contract
- Hours
- Variable hours
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- Nurse, Pharmacist
- Rate period
- Annual
Why this was classified this way
- contract
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Worth considering for LPNs with managed care exposure who want to transition off the bedside into payer-side utilization review and population health. The 4-year patient care requirement, Louisiana preference, and no-sponsorship policy make it a poor fit for IMGs on visas or clinicians without managed care background.
Who should apply
LPNs with at least 4 years of direct patient care and managed care or claims processing experience, ideally already in Louisiana or willing to relocate, and interested in utilization review, disease management, or care coordination. Less suitable for RNs, physicians, or IMGs requiring visa sponsorship.
CV angle
Reframe bedside LPN experience around clinical assessment, care planning, and coordination of services, and explicitly surface any managed care, claims, authorization, or medical review exposure. Highlight familiarity with ICD-10, CPT, HCPCS, Medicare guidelines, and medical terminology, and quantify caseloads, cost or quality outcomes, and multidisciplinary coordination to match payer-side ATS language.
Skills to highlight
- Clinical assessment and care planning
- Utilization review and prior authorization
- Managed care and claims processing
- ICD-10, CPT, and HCPCS coding knowledge
- Medicare guideline interpretation
- Disease management and population health
- Multidisciplinary communication with providers and members
- Case documentation and regulatory compliance
Role summary
A payer-side care coordination and utilization review position at Louisiana Blue (Blue Cross Blue Shield of Louisiana) within Population Health and Health Services. The nurse assesses member needs, develops and implements disease management plans, performs medical review and authorization work, and ensures quality and cost-effective outcomes while complying with laws, regulations, and accreditation standards.
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