RN I, PCA/MDC/DSNP

Job not on LinkedIn

🕒 3 days ago

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

💵 $70.5k - $94.4k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Horizon Connect @ Wall BCBSNJ

WebsiteLinkedInAll Job Openings

2 - 10 employees

⚕️ Healthcare Insurance

🏥 Healthcare

Healthcare Insurance • Healthcare

Horizon Connect @ Wall BCBSNJ is a LinkedIn presence or local program/office associated with Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ). Based on the name and context, it appears to be connected to Horizon BCBSNJ’s health insurance operations and local outreach or member/provider engagement in the Wall, NJ area. Publicly available information provided is limited and mostly LinkedIn site chrome rather than a company profile, so this description is conservative and based on the affiliation indicated by the name.

📋 Description

• Assesses patient's clinical need against established guidelines and/or standards • Evaluates the necessity, appropriateness and efficiency of service provided • Develops, coordinates and assists in implementation of services to meet the needs of the members • Coordinates with patient, family, physician, hospital and other external customers • Monitors patient's medical care activities, regardless of the site of service, and outcomes for appropriateness and effectiveness • Advocates for the member/family among various sites to coordinate resource utilization • Refers members to MLTSS when appropriate • Educates members on the availability of SNP if appropriate • Documents accurately and comprehensively based on the standards of practice

🎯 Requirements

• High School Diploma/GED required • Bachelor degree preferred or relevant experience in lieu of degree • A minimum of two (2) years clinical experience is preferred • Active Unrestricted NJ RN License Required • Proficiency in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes • Working knowledge of case/care management principles • Working knowledge of principles of utilization management • Prefers basic knowledge of health care contracts and benefit eligibility requirements • Prefers knowledge of hospital structures and payment systems

🏖️ Benefits

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