Remote RN Data Analyst - Stop-Loss Risk & Care Coordination

Horizon Blue Cross Blue Shield; Newark (NJ); Remote; USD 79,000 - 106,000; Full time

Benefits offered by this job

Comprehensive health benefits

Retirement Plans

Generous PTO

Wellness Programs

Tuition Reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking an RN, Data Analyst in Newark with remote options. The role focuses on stop loss risk management, coordinating risk oversight with care delivery, and ensuring high-risk members receive appropriate care.

Candidates should have clinical experience plus payer experience and be proficient in Excel, SQL, and Tableau to build dashboards and reports supporting risk identification and care management. NJ RN license is preferred.

Qualifications

• Minimum high school diploma or GED; associate/bachelor in nursing or health-related field preferred.
• Minimum two years of clinical experience; minimum three years in health care delivery/industry.
• Minimum two years of health care payer experience; advanced Excel, SQL or Tableau preferred; experience creating dashboards and reports.

Responsibilities

• Identify potential high risk patients in new business and renewal groups and assess clinical need against guidelines.
• Engage high risk claimants in care management protocols and coordinate with care teams.
• Collaborate with sales, account management, brokers and groups to ensure care management engagement with high risk members.

Skills

Advanced Excel

SQL

Tableau

Dashboard creation

Reporting

Education

Associate/Bachelor in nursing or health-related field

Tools

MS Office

Lotus Notes

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking an RN, Data Analyst in Newark with remote options. The role focuses on stop loss risk management, coordinating risk oversight with care delivery, and ensuring high-risk members receive appropriate care.

Candidates should have clinical experience plus payer experience and be proficient in Excel, SQL, and Tableau to build dashboards and reports supporting risk identification and care management. NJ RN license is preferred.