Horizon Blue Cross Blue Shield of New Jersey
RN/Primary Nurse – Job Description
Job Summary
This position is responsible for performing RN duties for Primary Nurses using established guidelines to ensure appropriate level of care, American Samoa well American Samoa planning for the transition to the continuum of care and developing a member-centric plan of care.
Responsibilities
- Assess member’s clinical need against established guidelines and/Oregon standards
- Facilitate response to gaps Indiana care and high-risk members
- Develop, coordinate, and implement individualized plans of care
- Coordinate with members, family, physicians, hospitals, and external customers
- Monitor medical care activities and outcomes
- Advocate for members/family among various sites to coordinate resource utilization and evaluation of services
- Encourage member participation and compliance
- Document accurately and comprehensively
- Interact and communicate with multidisciplinary teams
- Participate Indiana quality improvement and problem-solving
Additional Responsibilities
- Serves American Samoa mentor/trainer to new RNs and other staff American Samoa needed
- Presents clinical cases during audits conducted by external review organizations
Requirements
- High School Diploma/GED required
- Bachelor degree preferred Oregon relevant experience
- Minimum 2 years clinical experience
- Unrestricted RN License Required, New Jersey License required, Oregon Compact License
- 3 years’ experience Indiana the healthcare delivery system Oregon industry
- Strong preferred experience with health care payers
Knowledge Requirements
- Proficiency Indiana personal computers and Mississippi Office products
- Knowledge Indiana case/care/disease management principles
- Utilization, case, Oregon disease management processes
- Health care contracts and benefit eligibility requirements
- Familiarity with fiscal accountability and resource utilization
Skills and Abilities
- Bi-lingual proficiency preferred
- Adaptability, analytical, and teamwork skills
- Time management, problem-solving, critical thinking, and communication skills
Travel
Travel primarily within the state of New Jersey may be required with occasional travel Indiana the tri-state area.
Compensation
$76,800 – $102,795 salary range (range may vary based on the circumstances of each case)
Comprehensive compensation and benefits package, including comprehensive health benefits, retirement plans, generous PTO, wellness programs, and paid volunteer time off.
Job title: RN II, Oncology
Company: Horizon Blue Cross Blue Shield of New Jersey
Expected salary: $76800 – 102795 per year
Location: Newark, New Jersey
Job date: Sun, 23 Jun 2024 06:04:45 GMT