Population Health RN – Part-Time

Blue Cross and Blue Shield of Louisiana

Population Health RN coordinating care and case management services for at-risk members in Louisiana. Responsible for analyzing needs and implementing healthcare interventions.

Posted 7/10/2026part-timeRemote • Louisiana • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

Responsible for organizing, coordinating, and providing care coordination and case management services to members who are most at risk for health deterioration, sentinel events, and/or poor outcomes
Manage acute and chronically ill members to improve health and financial outcomes through analysis of needs, design, and delivery of interventions
Utilize a collaborative process to assess, plan, implement, monitor, and evaluate options and services required to meet the member’s healthcare needs
Through communication, the nurse will identify available resources to promote quality, cost effective outcomes
Accountable for complying with all laws, regulations and accreditation standards that are associated with duties and responsibilities
Develop and implement a plan by determining specific objectives, goals, and actions as identified through the assessment in action oriented and time specific indicators.
The case manager will act as an advocate for the member/family, maintaining privacy, confidentiality and safety, building relationships with all relevant parties, supporting informed decision making and facilitating access to necessary and appropriate healthcare services across the continuum of care.
Implement a comprehensive case management plan
Implement specific case management activities and/or interventions and evaluate effectiveness that will lead to accomplishing the goals established in the case management plan.
Coordinate by collaborating with the member/family, providers, third party payors, employers and community resources in order to organize, integrate, and modify the resources necessary to accomplish the goals.
Interacts with patients and/or providers in order to determine patient care needs, compliance and effectiveness with planned interventions and conduct case conferences as appropriate.
Evaluates the case management plan’s effectiveness in reaching desired outcomes and goals.
Modifies any or all of the case management plan’s components if necessary.
Responsible for meeting individual quality performance standards and annual targets for program performance, such as monthly productivity and annual caseload requirements, as mutually agreed to by management team to maximize program value.

Requirements

What you’ll need

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 the use of behavioral interviewing techniques and theory is preferred
Requires the ability to prioritize, work independently and anticipate needs to make decisions
Ability to plan, implement and evaluate appropriate healthcare services in conjunction with a physician treatment plan and evaluate the effectiveness of alternate care services are required
Requires the ability to research and analyze contracts/cases and make appropriate quality and cost effective decisions
Knowledge of standardized code sets and medical terminology is required
Must demonstrate excellent interpersonal, organizational, analytical, and telephonic skills
Must demonstrate strong communication skills, including the ability to effectively explain/present claims information and procedures to persons with varied levels of insurance/benefits understanding
Requires working knowledge of related software and office equipment.
Active and unencumbered(current and unrestricted) RN license to practice in Louisiana is required
Multi-state Compact RN license is preferred
Multi-state Compact RN license is required within 6 months from date of hire
RN license in noncompact state is preferred
May be required to obtain additional RN licensure in noncompact state within 6 months from date of hire
Certified Case Management Certification is preferred
Certified Case Management Certification is required within 3 years from date of hire.

Benefits

Comp & perks

We take great strides to ensure our employees have the resources to live well
Be healthy
Continue learning
Develop skills
Grow professionally
Serve our local communities

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Care CoordinationCase ManagementHealthcare Service EvaluationMedical TerminologyContract Analysis

Soft Skills

Interpersonal SkillsOrganizational SkillsAnalytical SkillsCommunication SkillsDecision-Making

Certifications

Active RN LicenseCertified Case Management Certification