RN II, Primary Nurse Care

IntelliResume; New Jersey; 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 Blue Cross Blue Shield of New Jersey seeks an experienced RN for the Primary Nurse population in Hopewell, NJ. You will apply established guidelines to plan transitions and develop member-centered care plans while coordinating with members and providers.

The role emphasizes care coordination for high-risk members, documenting per standards and mentoring new RNs. Requires RN license in NJ (or Compact), 2+ years clinical experience, and a Bachelor degree is preferred.

Qualifications

• RN-level clinical assessment and care planning experience.
• Experience coordinating care for high-risk members.
• Ability to document per standards of practice and organizational policies.

Responsibilities

• Assess member's clinical needs against guidelines to ensure appropriate services.
• Facilitate responses to gaps in care for high-risk members.
• Evaluate necessity and appropriateness of medical services for acute and chronic needs.
• Develop and coordinate individualized plans of care for members.
• Coordinate with members, families, and providers regarding care appropriateness.
• Monitor member care activities for effectiveness.
• Mentor/trainer to new RNs and staff as needed.

Skills

Clinical assessment

Care planning

High-risk member engagement

Documentation

Mentoring/training staff

Education

High School Diploma/GED

Bachelor degree preferred

Job description

About This Role

This position is responsible for performing RN duties for the Primary Nurse population using established guidelines to ensure appropriate levels of care, planning for transitions, and developing member-centric care plans. Ideal for those who are passionate about engaging high-risk members in preventative care opportunities.

Highlights

• Pay: $79,100 - $105,945/year
• Location: Hopewell, NJ
• Schedule: Full-time

What You'll Do

• Assess member's clinical needs against established guidelines to ensure medically appropriate services.
• Facilitate responses to gaps in care for high-risk members.
• Evaluate the necessity and appropriateness of medical services for acute and chronic needs.
• Develop and coordinate individualized plans of care for members.
• Coordinate with members, families, and healthcare providers regarding care appropriateness.
• Monitor member's medical care activities for appropriateness and effectiveness.
• Advocate for members among various sites to coordinate resource utilization.
• Encourage member participation in case/disease management programs.
• Document accurately based on standards of practice and organizational policies.
• Serve as a mentor/trainer to new RNs and other staff as needed.

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
• Minimum of three (3) years' experience in the healthcare delivery system/industry required
• Experience with both acute and chronic conditions preferred
• Health care payer experience strongly preferred

Licenses & Certifications

• Active Unrestricted RN License Required; NJ License required and/or Compact License
• Requires a valid Driver's License and Insurance

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. For over 90 years, they have been New Jersey’s health solutions leader, driving innovations that improve healthcare quality, affordability, and member experience.