RN Case Manager: Care Coordination & Mentorship

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 BCBSNJ in New Jersey is seeking an experienced RN to provide clinical advocacy within the payer-driven care continuum. You will assess care levels, coordinate with members, families, and providers, and mentor staff across projects and committees.

Join a team focused on high-quality, cost-effective care using guidelines, with opportunities to lead, test systems, and influence utilization management while supporting members through the healthcare journey.

Qualifications

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

Responsibilities

• Assess patient's clinical need against guidelines to ensure appropriate inpatient care.
• Coordinate and implement care plans for members across the continuum.
• Mentor RN staff and act as SME for projects and committees.
• Interact with multidisciplinary teams to ensure continuity of care.
• Document accurately per standards and participate in quality improvement.

Skills

Clinical assessment

Care management

Mentoring

Motivational Interviewing

Communication

Team collaboration

Education

High School Diploma/GED

Bachelor degree preferred

Tools

MS Office

Job description

Horizon BCBSNJ in New Jersey is seeking an experienced RN to provide clinical advocacy within the payer-driven care continuum. You will assess care levels, coordinate with members, families, and providers, and mentor staff across projects and committees.

Join a team focused on high-quality, cost-effective care using guidelines, with opportunities to lead, test systems, and influence utilization management while supporting members through the healthcare journey.