ZipRecruiter

Log In

2

Blue Cross Rn Remote Jobs in Bound Brook, NJ (NOW HIRING)

Oshi Health

GI- Nurse Practitioner

New Brunswick, NJ · Remote

Preferred RN compact License Required Location: We are only hiring from the following states ... Pursue cross-licensure opportunities and maintain good standing with all relevant licenses and ...

next page

Showing results 1-20

All JobsBlue Cross Rn JobsBlue Cross Rn Remote JobsBlue Cross Rn Remote Jobs in Bound Brook, NJ

Blue Cross Rn Remote information

What are the key skills and qualifications needed to thrive as a Blue Cross RN Remote, and why are they important?

To excel as a Blue Cross RN Remote, you need an active RN license, clinical nursing experience (often in case management or utilization review), and strong assessment abilities. Familiarity with electronic medical record (EMR) systems, telehealth platforms, and case management software is typically required, along with certifications like CCM (Certified Case Manager) being advantageous. Exceptional communication, self-motivation, and organizational skills help nurses effectively support members and collaborate virtually with healthcare teams. These competencies ensure quality patient care, regulatory compliance, and efficient service delivery in a remote environment.

What is the difference between Blue Cross Rn Remote vs Blue Cross Lpn Remote?

AspectBlue Cross Rn RemoteBlue Cross Lpn Remote
Required CredentialsRegistered Nurse (RN) licenseLicensed Practical Nurse (LPN) license
Work EnvironmentRemote healthcare support, patient assessmentsRemote patient care, basic clinical tasks
Employer & Industry UsageHealth insurance companies, healthcare providersHealth insurance companies, healthcare providers
Common Search & ComparisonYesYes

Blue Cross Rn Remote and Blue Cross Lpn Remote roles both serve in remote healthcare settings within insurance companies and healthcare providers. The main difference lies in the required credentials: RNs need a registered nurse license, while LPNs require a practical nurse license. RNs typically handle more complex patient assessments, whereas LPNs focus on basic patient care tasks. Both roles are essential in remote healthcare support, but they differ in scope and qualification requirements.

What is a Blue Cross RN Remote?

A Blue Cross RN Remote is a registered nurse who works remotely for Blue Cross Blue Shield, typically supporting members through telehealth, case management, care coordination, and health coaching. These nurses use phone, video calls, and digital platforms to assess patient needs, develop care plans, and provide education and support. Their role helps ensure that members receive high-quality care and guidance without needing in-person visits, making healthcare more accessible and convenient. Blue Cross RNs working remotely may also assist with pre-authorization, utilization management, or disease management programs.

How does a remote Blue Cross RN typically communicate and coordinate care with interdisciplinary team members?

As a remote Blue Cross RN, effective communication with physicians, case managers, social workers, and other healthcare professionals is essential. Most coordination occurs via secure digital platforms, video calls, and phone conferences, allowing for timely updates on patient progress and care plans. Regular virtual meetings and documentation in shared electronic health records ensure seamless teamwork and continuity of care. Building strong digital communication skills and being proactive about follow-ups are key to success in this remote setting.
What cities near Bound Brook, NJ are hiring for Blue Cross Rn Remote jobs? Cities near Bound Brook, NJ with the most Blue Cross Rn Remote job openings:
Blue Cross Rn Remote jobs near you

RN II - Primary Nurse Care

Horizon Blue Cross Blue Shield of New Jersey

Hopewell, NJ • On-site, Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 2 days ago

Horizon Blue Cross Blue Shield of New Jersey rating

8.0

Company rating: 8.0 out of 10

Based on 22 frontline employees who took The Breakroom Quiz

162nd of 301 rated insurance

Job description

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.
About the Role
This position is responsible for performing RN duties for the Primary Nurse population using established guidelines to ensure appropriate level of care, as well as, planning for the transition to the continuum of care and developing a member centric plan of care. Primary Nurses will outreach to high risk members and will work to engage members in preventative care opportunities & screenings when possible. This position will perform duties and types of care management as assigned by management. Serves as a mentor/trainer to new RN's and other staff as needed. Positions involving ASO accounts may require some travel for on-site availability.
What You'll Do
  • Assesses member's clinical need against established guidelines and/or standards to ensure that the services provided are medically appropriate to member's needs and aligned with the benefit structure.
  • Facilitates response to gaps in care and identified high risk members to appropriate settings of care for annual wellness visits including collaboration with treating provider.
  • Evaluates the necessity, appropriateness and efficiency of medical services and procedures provided for both acute and chronic health care needs.
  • Develops, coordinates and assists in implementation of individualized plan of care for members and identification of barriers towards Self-Management and optimal wellness.
  • Coordinates with members, family, physician, hospital and other external customers with respect to the appropriateness of care from diagnosis to outcome.
  • Coordinates the delivery of high quality, cost-effective care supported by clinical practice guidelines established by the plan addressing the entire continuum of care including transitional care.
  • Monitors member'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 and evaluation of services provided.
  • Encourages member participation and compliance in the case/disease management program efforts.
  • Documents accurately and comprehensively based on the standards of practice and current organization policies.
  • Interacts and communicates with multidisciplinary teams either telephonically and/or in person striving for continuity and efficiency as the member is managed along the continuum of care.
  • Evaluates care by problem solving, analyzing variances and participating in the quality improvement program to enhance member outcomes.
  • Serves as mentor/trainer to new RN's and other staff as needed
  • Presents clinical cases during audits conducted by external review organizations.
  • Performs other duties as assigned by management.

What You Bring
Education/Experience:
  • High School Diploma/GED required.
  • Bachelor degree preferred or relevant experience in lieu of degree.
  • Requires a minimum of two (2) years clinical experience. Experience with both acute and chronic conditions preferred.
  • Requires a minimum of three (3) years' experience in the health care delivery system/industry.
  • Experience with health care payer experience strongly preferred.

Additional licensing, certifications, registrations:
  • Active Unrestricted RN License Required; NJ License required and/or Compact License.
  • Requires a valid Driver's License and Insurance.

Knowledge:
  • Requires proficiency in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, and PowerPoint) and Microsoft Outlook. Prefers knowledge in the use of intranet and internet applications.
  • Requires working knowledge of case/care/disease management principles.
  • Requires working knowledge of operations of utilization, case and/or disease management processes.
  • Requires working knowledge of principles of utilization management.
  • Requires basic knowledge of health care contracts and benefit eligibility requirements.
  • Requires knowledge of hospital structures and payment systems.
  • Prefers understanding of fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes.

Skills and Abilities:
  • Bi-lingual proficiency preferred.
  • Adaptability/Flexibility.
  • Analytical.
  • Compassion.
  • Information/Knowledge Sharing.
  • Interpersonal & Client Relationship.
  • Sound decision making.
  • Active listening.
  • Organization Planning/Priority Setting.
  • Problem Solving/Critical Thinking.
  • Team Player.
  • Time Management.
  • Written/Oral Communications.

Travel:
  • Travel primarily within State of NJ may be required. Occasional travel in the tri-state area may also be required.

Why Horizon?
At Horizon, you'll do meaningful work that directly improves lives-while being supported by a mission-driven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too. If you are passionate about making an impact, we'd love to hear from you!
Salary Range:
$79,100 - $105,945
This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:
  • Comprehensive health benefits (Medical/Dental/Vision)
  • Retirement Plans
  • Generous PTO
  • Incentive Plans
  • Wellness Programs
  • Paid Volunteer Time Off
  • Tuition Reimbursement

Disclaimer:
Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.
Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

What Horizon Blue Cross Blue Shield of New Jersey employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply