Field RN Care Coordinator - PCA/MDC/DSNP

Horizon-Blue-Cross-Blue-Shield-of-New-Jersey; Newark (NJ); On-site; USD 71,000 - 94,000; 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 to perform PCA and MDC assessments, ensuring medically appropriate care and alignment with benefit structures. The role requires coordinating with patients, families, physicians, and hospitals to optimize outcomes.

Requires NJ RN license, two years clinical experience preferred, and proficiency with MS Office, strong communication and problem-solving skills, and willingness to travel locally.

Qualifications

• High School Diploma/GED required.
• Bachelor degree preferred or relevant experience in lieu of degree.
• A minimum of two (2) years clinical experience is preferred.

Responsibilities

• Assess patient's clinical need against guidelines to ensure services are medically appropriate.
• Evaluate necessity, appropriateness and efficiency of services provided.
• Coordinate and assist in implementation of services to meet member needs.
• Communicate with patient, family, physician, and hospital to ensure appropriateness of care.
• Monitor care activities and outcomes for effectiveness and quality.

Skills

Analytical

Compassionate

Interpersonal skills

Decision making

Active listening

Organization & planning

Problem solving

Team player

Time management

Communication skills

Education

High School Diploma/GED

Bachelor's degree preferred

Tools

MS Office

Lotus Notes

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a field-based Registered Nurse to perform PCA and MDC assessments, ensuring medically appropriate care and alignment with benefit structures. The role requires coordinating with patients, families, physicians, and hospitals to optimize outcomes.

Requires NJ RN license, two years clinical experience preferred, and proficiency with MS Office, strong communication and problem-solving skills, and willingness to travel locally.