RN, RN Nurse

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.

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

• 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.

• 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

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

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.