RN I

IntelliResume; New Jersey; 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 registered nurse to perform clinical duties and coordinate patient care within established guidelines. The role focuses on transitions in the continuum of care and meaningful impact on patient management in Hopewell, NJ.

Ideal candidates have at least two years of clinical experience, a valid NJ RN license or Compact license, and a Bachelor’s degree or relevant experience.

Qualifications

• RN responsibilities and clinical coordination experience are required.
• Two years of clinical experience minimum.
• Active NJ RN license or active Compact license required.

Responsibilities

• Assess patient needs against guidelines to ensure appropriate inpatient care.
• Evaluate necessity and efficiency of medical services and procedures.
• Coordinate and assist in implementing care plans for members.
• Monitor and coordinate services outside the network and negotiate fees as appropriate.
• Coordinate with patients, families, physicians, and hospitals regarding care appropriateness.
• Deliver high-quality, cost-effective care supported by clinical guidelines.
• Document patient care activities accurately per standards and policies.

Skills

RN duties

Clinical coordination

Education

High School Diploma/GED

Bachelor degree or relevant experience

Job description

About This Role

This position is responsible for performing RN duties using established guidelines to ensure appropriate levels of care and planning for transitions in the continuum of care. It is ideal for those with clinical experience looking to make a meaningful impact in patient management.

Highlights

• Pay: $70,500 - $94,395/year
• Location: Hopewell, NJ
• Schedule: Full-time

What You'll Do

• Assess patient's clinical needs against established guidelines to ensure appropriate inpatient care.
• Evaluate the necessity, appropriateness, and efficiency of medical services and procedures.
• Coordinate and assist in the implementation of care plans for members.
• Monitor and coordinate services rendered outside of the network and negotiate fees as appropriate.
• Coordinate with patients, families, physicians, and hospitals regarding care appropriateness.
• Deliver high-quality, cost-effective care supported by clinical practice guidelines.
• Monitor patient medical care activities and outcomes for appropriateness and effectiveness.
• Advocate for members/families to coordinate resource utilization and service evaluation.
• Encourage member participation and compliance in case/disease management programs.
• Document accurately and comprehensively based on standards of practice and policies.

Requirements

• Education:
  • High School Diploma/GED required
  • Bachelor degree preferred or relevant experience in lieu of degree
• Experience:
  • Minimum of two (2) years clinical experience required
• Licenses & Certifications:
  • Active Unrestricted NJ RN License or active Compact License required

Benefits

• Comprehensive health benefits (Medical/Dental/Vision)
• Retirement Plans
• Generous PTO
• Incentive Plans
• Wellness Programs
• Paid Volunteer Time Off
• Tuition Reimbursement

About Horizon Blue Cross Blue Shield NJ

Horizon Blue Cross Blue Shield of New Jersey is a leading healthcare provider committed to delivering exceptional patient care. With over 90 years of experience, they focus on improving healthcare quality, affordability, and member experience for over 3.5 million people.