RN I

Horizon Blue Cross Blue Shield of New Jersey empowers its members to achieve their best health by driving innovations that improve healthcare quality, affordability, and member experience. This role is responsible for performing RN duties using established guidelines to ensure appropriate level of care and planning for the transition to the continuum of care.

Requirements

• Assesses patient's clinical need against established guidelines and/or standards
• Evaluates the necessity, appropriateness and efficiency of medical services and procedures provided
• Coordinates and assists in implementation of plan for members
• Monitors and coordinates services rendered outside of the network
• Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided
• Encourages member participation and compliance in the case/disease management program efforts
• Documents accurately and comprehensively based on the standards of practice and current organization policies
• Interacts and communicates with multidisciplinary teams to coordinate resource utilization and evaluation of services provided
• Evaluates care by problem solving, analyzing variances and participating in the quality improvement program

Benefits

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