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Utilization Review RN - Care Quality & Compliance; LA)

Job in Lane, Williamsburg County, South Carolina, 29564, USA
Listing for: Blue Cross and Blue Shield of Louisiana Inc.
Full Time position
Listed on 2026-08-25
Job specializations:
  • Nursing
Salary/Wage Range or Industry Benchmark: 70000 - 95000 USD Yearly USD 70000.00 95000.00 YEAR
Job Description & How to Apply Below
Position: Utilization Review RN - Care Quality & Compliance (LA)
Location: Lane

Blue Cross and Blue Shield of Louisiana seeks a Registered Nurse to coordinate and manage inpatient and outpatient claims, ensuring medical necessity and contractual compliance. The role involves identifying improvement opportunities and maintaining strict regulatory standards across URAC, MNRO, and DOL guidelines.

Preferred candidates hold a Louisiana nursing license and may obtain CPUR/CPC within 24 months.

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