Field-Based RN Case Manager & Care Coordinator

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

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a field-based nurse case manager to assess members and develop person-centered care plans in collaboration with multidisciplinary teams.

The role requires a valid NJ RN license and a minimum of two years of clinical experience, with daily travel to support member care. Strong analytical, communication, and organizational skills are essential for success in this position.

Qualifications

• High School Diploma/GED required.
• Bachelor degree preferred or relevant experience.
• Minimum of two years clinical experience.

Responsibilities

• Performs assessments against guidelines to ensure medically appropriate care.
• Evaluates necessity and efficiency of services provided.
• Develops, coordinates and assists in implementation of member care plans.
• Coordinates with patient, family, physician and hospitals on care.
• Monitors care activities and outcomes for quality and effectiveness.
• Advocates for members across sites to coordinate resources.
• Encourages member participation and compliance with programs.
• 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 completes other duties.

Skills

Analytical

Compassionate

Interpersonal skills

Decision making

Active listening

Organization

Problem solving

Team player

Time management

Communication skills

Education

Bachelor's degree preferred

High School Diploma/GED required

Tools

Windows OS & MS Office

Lotus Notes

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a field-based nurse case manager to assess members and develop person-centered care plans in collaboration with multidisciplinary teams.

The role requires a valid NJ RN license and a minimum of two years of clinical experience, with daily travel to support member care. Strong analytical, communication, and organizational skills are essential for success in this position.