Registered Nurse-Program Coordinator

State of Louisiana • Baton Rouge, LA

2d • Onsite

About The Position

The Registered Nurse-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.

Requirements

• Possession of a current Louisiana Registered Nurse license or a temporary permit or multi-state license issued by a Nursing Licensure Compact (NLC/eNLC) state to practice as a registered nurse
• Three years of experience as a licensed registered nurse
• A bachelor's degree in nursing plus two years of experience as a licensed registered nurse
• A master's degree in nursing or public health plus two years of experience as a licensed registered nurse
• A doctorate in nursing or public health plus one year of experience as a licensed registered nurse

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level