RN I, PCA/MDC/DSNP (Field Based - Cape May/Southern Atlantic Counties)

About This Role This field-based position is responsible for performing assessments for PCA and MDC services using established guidelines to ensure appropriate levels of care and services are authorized. Highlights Pay: $70,500 - $94,395/year Location: Hopewell, NJ Schedule: Full-time What You'll Do Assess patient’s clinical need against established guidelines to ensure services are medically appropriate. Evaluate the necessity, appropriateness, and efficiency of services provided. Develop, coordinate, and assist in the implementation of services to meet member needs. Coordinate with patients, families, physicians, and hospitals regarding care appropriateness. Monitor patient’s medical care activities and outcomes for appropriateness and effectiveness. Advocate for members/families among various sites to coordinate resource utilization. Refer members to MLTSS when appropriate. Educate members on the availability of SNP if appropriate. Document accurately and comprehensively based on standards of practice. Interact and communicate with multidisciplinary teams to ensure continuity of care. Requirements Education High School Diploma/GED required Bachelor degree preferred or relevant experience in lieu of degree Experience A minimum of two (2) years clinical experience preferred Licenses & Certifications Active Unrestricted NJ RN License required 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 empowers members to achieve their best health. For over 90 years, they have been New Jersey’s health solutions leader, driving innovations that improve healthcare quality, affordability, and member experience. #J-18808-Ljbffr Horizon Blue Cross Blue Shield NJ