Field-Based RN Care Manager — Patient-Focused & Collaborative

Horizon Blue Cross Blue Shield of New Jersey; Hopewell (VA); On-site; USD 79,000 - 106,000; Full time

Benefits offered by this job

Comprehensive health benefits (Medical

Retirement Plans

Generous PTO

Incentive Plans

Wellness Programs

Paid Volunteer Time Off

Tuition Reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a field-based RN Case Manager to assess members and develop care plans using established guidelines.

This role requires an active NJ RN license, a minimum of two years of clinical experience, and daily local travel. You will coordinate with healthcare teams to ensure appropriate, cost-effective care across the continuum and advocate for members and families.

Qualifications

• High School Diploma or GED required; Bachelor degree preferred or equivalent experience.
• Minimum two years clinical experience.
• Active Unrestricted NJ RN License Required.

Responsibilities

• Assesses member’s clinical need against established guidelines to ensure appropriate care.
• Evaluates the necessity and efficiency of services provided.
• Develops and coordinates an individualized plan of care.
• Coordinates with patient, family, physician, hospital and other external customers.
• Delivers high quality, cost-effective care across the continuum.
• Monitors care activities and outcomes for appropriateness and effectiveness.
• Advocates for the member/family across sites to coordinate resources.
• Encourages member participation and compliance in the program.
• Documents accurately per standards and policies.
• Interacts with multidisciplinary teams to ensure continuity of care.
• Understands fiscal accountability and impact on resource utilization.
• Participates in quality improvement activities and problem solving.

Skills

Analytical

Compassionate

Interpersonal & Client Relationship B

Sound Decision Making

Active Listening

Organization/Planning/Priority Setting

Problem Solving/Critical Thinking

Team Player

Time Management

Written/Oral Communication Skills

Education

High School Diploma/GED

Bachelor degree preferred or relevant experience in lieu of degree

Tools

MS Office

Lotus Notes

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a field-based RN Case Manager to assess members and develop care plans using established guidelines.

This role requires an active NJ RN license, a minimum of two years of clinical experience, and daily local travel. You will coordinate with healthcare teams to ensure appropriate, cost-effective care across the continuum and advocate for members and families.