RN Field Care Manager

Horizon Blue Cross Blue Shield of New Jersey; The Ironbound (NJ); On-site; USD 79,100 - 105,945; Full time

Benefits offered by this job

Health benefits

Retirement plans

Generous PTO

Incentive plans

Wellness program

Volunteer time off

Tuition reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a field-based registered nurse to perform member assessments using established guidelines and to develop a member-centric plan of care.

You will coordinate with patients, families, physicians, hospitals and other external stakeholders to ensure appropriate care from diagnosis to outcome, work across multidisciplinary teams, document care, and participate in quality improvement initiatives while traveling daily in New Jersey.

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 Unrestricted NJ RN License Required.

Responsibilities

• Assesses member's clinical need against guidelines to ensure medically appropriate services.
• Evaluates necessity, appropriateness and efficiency of services provided.
• Develops and coordinates member-centered plan of care.
• Coordinates with patient, family, physician, hospital and other external customers regarding care.
• Monitors member's medical care activities and outcomes for appropriateness and effectiveness.
• Documents accurately based on standards of practice and policies.
• Interacts with multidisciplinary teams to ensure continuity of care.
• Engages in quality improvement to enhance member outcomes.

Skills

Analytical

Compassionate

Interpersonal skills

Decision making

Active listening

Organization & planning

Problem solving

Team player

Time management

Written communication

Oral communication

Education

RN license

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a field-based registered nurse to perform member assessments using established guidelines and to develop a member-centric plan of care.

You will coordinate with patients, families, physicians, hospitals and other external stakeholders to ensure appropriate care from diagnosis to outcome, work across multidisciplinary teams, document care, and participate in quality improvement initiatives while traveling daily in New Jersey.