RN II Case Management | Mentor & Care Coordinator

Horizon-Blue-Cross-Blue-Shield-of-New-Jersey; Hopewell (NJ); On-site; USD 79,000 - 106,000; Full time

Benefits offered by this job

Comprehensive benefits

PTO

Retirement plans

Tuition reimbursement

Wellness programs

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a registered nurse to perform care management duties, coordinate inpatient and continuum-of-care transitions, and mentor staff. You will assess clinical needs, evaluate services, and collaborate with providers, facilities, and families to ensure appropriate, cost-effective care.

Ideal candidates have at least two years of clinical experience and two years in health care payer settings, with an active NJ RN license (or compact) and strong

Qualifications

• Active NJ RN license (or Compact) required.
• Minimum 2 years clinical experience.
• Minimum 2 years health care payer experience.

Responsibilities

• Assess patient's clinical need against guidelines to ensure appropriate level of care.
• Evaluate necessity and efficiency of medical services and procedures.
• Coordinate and implement care plans with members, families, and providers.
• Monitor services outside the network and negotiate fees as appropriate.
• Mentor/trainer to new staff and participate in quality improvement.

Skills

RN clinical experience

Case management

Motivational interviewing

Communication skills

Teamwork

Education

Active NJ RN License

Compact License (NJ)

Tools

MS Office

Hospital systems

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a registered nurse to perform care management duties, coordinate inpatient and continuum-of-care transitions, and mentor staff. You will assess clinical needs, evaluate services, and collaborate with providers, facilities, and families to ensure appropriate, cost-effective care.

Ideal candidates have at least two years of clinical experience and two years in health care payer settings, with an active NJ RN license (or compact) and strong