Onsite RN Data Analyst: Stop-Loss Risk & Care Management

Horizon Blue Cross Blue Shield of New Jersey; Newark (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

Tuition Reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is hiring an RN Data Analyst in Newark, NJ for its centralized stop loss team. This onsite role supports risk management activities and coordinates risk oversight with care delivery teams to promote medically necessary care and appropriate transitions.

The ideal candidate holds an active NJ RN license, with 2+ years clinical and 3+ years healthcare payer experience, plus hands-on SQL/Tableau skills to develop dashboards and reports.

Qualifications

• Must have an active NJ Registered Nurse License.
• Associate’s or Bachelor’s degree (or higher) in nursing or health field, or accredited diploma nursing school.
• Minimum two years of clinical experience.

Responsibilities

• Partner with care management and delivery functions to identify high risk patients and assess clinical need against guidelines.
• Engage high risk claimants in care management protocols and coordinate outreach across stakeholders.
• Support care management engagement for high risk members with sales, brokers, consultants, and group customers.
• Provide coordination for supporters of high risk patients, including families and employers.

Skills

Nurse license

Clinical experience

Payer experience

Cross-functional collaboration

SQL

Excel

Tableau

Dashboard/report creation

MS Office

Communication

Education

Nursing degree or higher

Tools

Excel

SQL

Tableau

Job description

Horizon Blue Cross Blue Shield of New Jersey is hiring an RN Data Analyst in Newark, NJ for its centralized stop loss team. This onsite role supports risk management activities and coordinates risk oversight with care delivery teams to promote medically necessary care and appropriate transitions.

The ideal candidate holds an active NJ RN license, with 2+ years clinical and 3+ years healthcare payer experience, plus hands-on SQL/Tableau skills to develop dashboards and reports.