RN II, Primary Nurse Care

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. #J-18808-Ljbffr Horizon Blue Cross Blue Shield NJ