Field-Based RN II: Care Coordination & Outcomes

100 Horizon Healthcare Services, Inc; Hopewell (NJ); On-site; USD 79,000 - 106,000; Full time

Benefits offered by this job

Comprehensive health benefits

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 Registered Nurse (RN) to assess members and develop a member-centric plan of care according to guidelines, coordinating with patients, families, physicians, and hospitals for appropriate, cost-effective care across the continuum.

The ideal candidate holds an active NJ RN license with at least 2 years of clinical experience and knowledge of utilization/case management. Daily travel within New Jersey is required.

Qualifications

• High School Diploma/GED required.
• Bachelor degree preferred or relevant experience in lieu of degree.
• Requires a minimum of two (2) years clinical experience.
• Active NJ RN License Required.
• Proficiency in MS Office and Lotus Notes; Windows-based environment.

Responsibilities

• Assesses member's clinical need against guidelines to ensure medical appropriateness.
• Evaluates necessity, appropriateness and efficiency of services.
• Develops, coordinates and assists in implementation of member's plan of care.
• Coordinates with patient, family, physician, hospital and other external customers.
• Delivers high quality, cost-effective care aligned with practice guidelines.
• Monitors medical care activities and outcomes for appropriateness and effectiveness.
• Advocates for member/family across care sites to coordinate resource utilization.
• Encourages member participation and compliance in the program.
• Documents accurately per standards and policies.
• Interacts with multidisciplinary teams, telephonically or in person, for continuity of care.
• Manages fiscal accountability and evaluates care outcomes.

Skills

Analytical

Compassionate

Interpersonal & Client Relationship

Decision Making

Active Listening

Organization & Planning

Problem Solving & Critical Thinking

Team Player

Time Management

Written & Oral Communication

Education

High School Diploma/GED

Bachelor's degree preferred or relevant experience in lieu of degree

Tools

MS Office

Lotus Notes

Windows-based environment

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a field-based Registered Nurse (RN) to assess members and develop a member-centric plan of care according to guidelines, coordinating with patients, families, physicians, and hospitals for appropriate, cost-effective care across the continuum.

The ideal candidate holds an active NJ RN license with at least 2 years of clinical experience and knowledge of utilization/case management. Daily travel within New Jersey is required.