Serves as mentor/trainer to new RN's and other staff as needed. Subject matter expert for the various projects and committees as needed. What You'll Do * Assesses patient's clinical need against ...
Serves as mentor/trainer to new RN's and other staff as needed. Subject matter expert for the various projects and committees as needed. What You'll Do * Assesses patient's clinical need against ...
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 ...
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 ...
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 SHIFT TIME:11AM-8PM (M-F ...
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 SHIFT TIME:11AM-8PM (M-F ...
True Care Solutions is actively seekingexperienced Per Diem Infusion Registered Nurses(RNs)to provide high-quality infusion therapy in patients homes acrossall five boroughs of New York City and ...
Quick apply
True Care Solutions is actively seekingexperienced Per Diem Infusion Registered Nurses(RNs)to provide high-quality infusion therapy in patients homes acrossall five boroughs of New York City and ...
RN Care Manager (DSNP)
New York, NY · Remote
SUMMARY The Registered Nurse (RN) Care Manager for Belong Health's DSNP program is responsible for ... Ability to work independently and effectively within a fully remote and highly collaborative team ...
RN Care Manager (DSNP)
New York, NY · Remote
SUMMARY The Registered Nurse (RN) Care Manager for Belong Health's DSNP program is responsible for ... Ability to work independently and effectively within a fully remote and highly collaborative team ...
Risk Management Nurse Consultant - Pennsylvania
Doylestown, PA · Remote
$100K - $120K/yr
Active RN license * Minimum of 3-5 years' experience in a leadership role * Risk Management ... Remote
Quick apply
Risk Management Nurse Consultant - Pennsylvania
Doylestown, PA · Remote
$100K - $120K/yr
Active RN license * Minimum of 3-5 years' experience in a leadership role * Risk Management ... Remote
*Nurse Case Manager II - New York
New York, NY · On-site +1
$44.14 - $48/hr
Remote Work Type: Remote Est. Pay Range: $44.14/hr. To $48.00/hr. All-inclusive on W2 Position ... Active, unrestricted RN license in the state of New York. * Minimum of 3 years of clinical ...
*Nurse Case Manager II - New York
New York, NY · On-site +1
$44.14 - $48/hr
Remote Work Type: Remote Est. Pay Range: $44.14/hr. To $48.00/hr. All-inclusive on W2 Position ... Active, unrestricted RN license in the state of New York. * Minimum of 3 years of clinical ...
Case Manager Registered Nurse - Field in Middlesex County NJ
East Brunswick, NJ · Remote
$66K - $142K/yr
Case Manager, Registered Nurse (Field-Based) - Middlesex County, NJ Position Summary We're seeking ... This is a remote role with up to 75% field travel, Monday-Friday from 8:00 AM-5:00 PM EST. In this ...
Case Manager Registered Nurse - Field in Middlesex County NJ
East Brunswick, NJ · Remote
$66K - $142K/yr
Case Manager, Registered Nurse (Field-Based) - Middlesex County, NJ Position Summary We're seeking ... This is a remote role with up to 75% field travel, Monday-Friday from 8:00 AM-5:00 PM EST. In this ...
The RN will be responsible for providing telephone and in-person advice and education to patients. This role requires offering interventions, counseling, and support services that require significant ...
Quick apply
The RN will be responsible for providing telephone and in-person advice and education to patients. This role requires offering interventions, counseling, and support services that require significant ...
Meritain Pharmacy Solutions Clinical CARE Specialist - RN/LVN/LPN
New York, NY · Remote
$82K - $182K/yr
This is fully remote position eligible candidates may live anywhere in the contiguous Unite States ... Active, unrestricted Registered Nurse (RN), Licensed Practical Nurse (LPN), or Licensed Vocational ...
Meritain Pharmacy Solutions Clinical CARE Specialist - RN/LVN/LPN
New York, NY · Remote
$82K - $182K/yr
This is fully remote position eligible candidates may live anywhere in the contiguous Unite States ... Active, unrestricted Registered Nurse (RN), Licensed Practical Nurse (LPN), or Licensed Vocational ...
DRG Clinical Validation Nurse
New York, NY · Remote
$85K - $95K/yr
We are seeking a registered nurse with experience in clinical validation to work within our coding ... Ability to use Windows PC with the ability to utilize multiple applications at the same time Remote ...
Quick apply
DRG Clinical Validation Nurse
New York, NY · Remote
$85K - $95K/yr
We are seeking a registered nurse with experience in clinical validation to work within our coding ... Ability to use Windows PC with the ability to utilize multiple applications at the same time Remote ...
Remote 1099 NPs & APRNs - Hormone Replacement Therapy
New York, NY · Remote
$60 - $90/hr
Active NP or APRN licenses in a minimum of 6 U.S. states * Active, unrestricted DEA license ... patient experience Remote Flexibility Work from home with scheduling options that fit your ...
Quick apply
Remote 1099 NPs & APRNs - Hormone Replacement Therapy
New York, NY · Remote
$60 - $90/hr
Active NP or APRN licenses in a minimum of 6 U.S. states * Active, unrestricted DEA license ... patient experience Remote Flexibility Work from home with scheduling options that fit your ...
Chronic Care Manager (Remote - Compact States)
New York, NY · Remote
$10/hr
Remote Join our mission to help transform healthcare delivery from reactive, episodic care to ... Current COMPACT license to practice as an RN/ LVN/LPN held in current state of residence with no ...
Chronic Care Manager (Remote - Compact States)
New York, NY · Remote
$10/hr
Remote Join our mission to help transform healthcare delivery from reactive, episodic care to ... Current COMPACT license to practice as an RN/ LVN/LPN held in current state of residence with no ...
Remote NPs - Hormone Replacement Therapy (Telehealth) 1099
New York, NY · Remote
$60 - $90/hr
Active NP or APRN licenses in a minimum of 6 U.S. states * Active, unrestricted DEA license ... patient experience Remote Flexibility Work from home with scheduling options that fit your ...
Quick apply
Remote NPs - Hormone Replacement Therapy (Telehealth) 1099
New York, NY · Remote
$60 - $90/hr
Active NP or APRN licenses in a minimum of 6 U.S. states * Active, unrestricted DEA license ... patient experience Remote Flexibility Work from home with scheduling options that fit your ...
RN I
Hopewell, NJ · On-site +1
$70K - $94K/yr
About the Role This position is responsible for performing RN duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care.
RN I
Hopewell, NJ · On-site +1
$70K - $94K/yr
About the Role This position is responsible for performing RN duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care.
RN I
Hopewell, NJ · On-site +1
$70K - $94K/yr
About the Role This position is responsible for performing RN duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care.
RN I
Hopewell, NJ · On-site +1
$70K - $94K/yr
About the Role This position is responsible for performing RN duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care.
RN II- CASE MGR.TRANSPLANT(REMOTE) HCC
Hopewell, NJ · On-site +1
Serves as mentor/trainer to new RN's and other staff as needed. Subject matter expert for the various projects and committees as needed. What You'll Do SHIFT TIME: 11am-8pm The Transplant Case ...
RN II- CASE MGR.TRANSPLANT(REMOTE) HCC
Hopewell, NJ · On-site +1
Serves as mentor/trainer to new RN's and other staff as needed. Subject matter expert for the various projects and committees as needed. What You'll Do SHIFT TIME: 11am-8pm The Transplant Case ...
Sub-Acute RN UM Reviewer - Medicare
New York, NY · Remote
$69K - $92K/yr
Remote Pay Transparency MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith ...
Sub-Acute RN UM Reviewer - Medicare
New York, NY · Remote
$69K - $92K/yr
Remote Pay Transparency MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith ...
Telehealth Nurse Practitioner | Remote 1099 | Structured Intake & Care Navigation About Baba Baba ... Active Nurse Practitioner or APRN license, in good standing - licensed in multiple states ...
Quick apply
Telehealth Nurse Practitioner | Remote 1099 | Structured Intake & Care Navigation About Baba Baba ... Active Nurse Practitioner or APRN license, in good standing - licensed in multiple states ...
Utilization Management Nurse Consultant
New York, NY · Remote
$29.10 - $62.32/hr
UM Nurse Consultant Fully Remote- WFH Schedule : Tuesday-Saturday 9:30am-6:00pm Position Summary ... Required Qualifications -Must have 3+ years of Med Surg experience as an RN in the hospital setting ...
Utilization Management Nurse Consultant
New York, NY · Remote
$29.10 - $62.32/hr
UM Nurse Consultant Fully Remote- WFH Schedule : Tuesday-Saturday 9:30am-6:00pm Position Summary ... Required Qualifications -Must have 3+ years of Med Surg experience as an RN in the hospital setting ...
Remote Rn information
What are some common challenges remote RNs face and how can they overcome them?
What is the difference between Remote Rn vs Remote Lpn?
| Aspect | Remote Rn | Remote Lpn |
|---|---|---|
| Required Credentials | Registered Nurse (RN) license, BSN often preferred | Licensed Practical Nurse (LPN) license |
| Work Environment | Hospitals, clinics, telehealth platforms | Long-term care, home health, telehealth |
| Employer & Industry Usage | Hospitals, healthcare providers, telehealth companies | Long-term care facilities, home health agencies |
Remote Rns typically hold a registered nurse license and work in hospitals or telehealth settings, providing comprehensive patient care. Remote Lpns, with a practical nurse license, often work in long-term care or home health. While both roles involve remote patient interaction, Rns usually handle more complex cases, whereas Lpns focus on basic patient care tasks.
What are the key skills and qualifications needed to thrive as a Remote RN, and why are they important?
What is the best remote job for a nurse?
How can I make 2000 a week working from home?
How to Become a Remote RN
To become a remote nurse, you need the same training, education, and qualifications that non-remote nurses possess, namely nursing licensure in your state. Some virtual RN roles may also require some period of on-site training to learn procedures. Since your duties include performing patient triage via telephone, webcam, or chat apps, you also need strong technical skills and a high-speed internet connection. Fluency in more than one language is a big plus, as is a strong track record of success in self-directed roles. Additionally, a variety of telehealth certifications are available, and these increase your appeal with potential employers.
How to make 300,000 as a nurse online?
What are Remote RNs?
How to make an extra $2000 a month as a nurse?
RN II - Oncology Case Manager-REMOTE BASED
Hopewell, NJ • On-site, Remote
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 21 days ago
Horizon Blue Cross Blue Shield of New Jersey rating
8.0
Based on 22 frontline employees who took The Breakroom Quiz
145th of 281 rated insurance
Job description
About the Role
This position is responsible for performing RN duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care. Performs duties and types of care management as assigned by management. Serves as mentor/trainer to new RN's and other staff as needed. Subject matter expert for the various projects and committees as needed.
What You'll Do
- Assesses patient's clinical need against established guidelines and/or standards to ensure that the level of care and length of stay of the patient are medically appropriate for inpatient stay.
- Evaluates the necessity, appropriateness and efficiency of medical services and procedures provided.
- Coordinates and assists in implementation of plan for members.
- Monitors and coordinates services rendered outside of the network, as well as outside the local area, and negotiate fees for such services as appropriate. Coordinates with patient, 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.
- 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 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.
- Understands fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes.
- 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.
- Acts as subject matter expert for respective area for projects.
- May assume leadership type activities in team leads absence.
- Represent clinical teams within committee meetings
- Present reports required at committee meetings.
- Subject matter expert for user acceptance testing for medical management system.
Addendum for Horizon Clinical Advocate Roles:
- Outreaches to members identified by Horizon as needing Clinical Advocate services.
- Applies critical thinking and clinical expertise to maximize outcomes while interacting with members and their families in a fast-paced environment.
- Builds trusting relationships with members and their families utilizing Motivational Interviewing techniques.
- Becomes knowledgeable in ASO client employer -sponsored benefits to assist members with questions related to medical benefits, claims, care coordination and other complex needs through explaining benefits and providing education and resources in plain language.
- Advocates for members consistently throughout their healthcare journey by coordinating with members, family, physician, hospital and other external customers with respect to the appropriateness of care from diagnosis to outcome.
- Focuses on whole person approach, by eliminating "homework" or unnecessary burdens on the members, we can provide a more supportive and engaging experience that addresses overall well-being physical, mental, and emotional.
- Schedule: 8- or 10-hour workday Monday through Friday varying between 8am and 11pm.
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.
- Requires minimum of two (2) years' experience with health care payer experience.
Utilization Management Only(Utilization Inpatient Case Management does NOT apply to RN II role within HCS) :
- RN's are required to work a specified number of weekends and holidays to meet Regulatory and Accrediting body standards. Requirements may vary based on department's business needs.
Additional licensing, certifications, registrations:
- Active Unrestricted NJ RN License or active Compact License Required.
Addendum for Horizon Clinical Advocate roles:
- CCM certification preferred.
Knowledge:
- Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint and Outlook). Should be knowledgeable in the use of intranet and internet applications.
- Requires knowledge of hospital structures and payment systems.
- Requires working knowledge of case/care/disease management principles.
- Requires working knowledge of operations of utilization, case and/or disease management processes.
- Requires knowledge of health care contracts and benefit eligibility requirements.
- Requires mentoring knowledge on the operations of utilization/case/disease management.
Addendum for Horizon Clinical Advocate roles:
- Requires ability to be an empathetic critical thinker.
- Requires excellent communication and organizational skills and a high tolerance for ambiguity.
- Ability to understand and communicate members benefits, claims and coordination focusing on advocacy principals and effective utilization.
- Experience in active listening and motivational interviewing strongly preferred.
- Requires a candidate that can work in a collaborative team environment and is a team player who possesses strong analytical, critical thinking and interpersonal skills.
- Requires exceptional multi-channel Communication and Interpersonal skills, including the ability to explain complex concepts clearly with compassion.
Skills and Abilities:
- Adaptability/Flexibility
- Analytical
- Compassion
- Interpersonal & Client Relationship Skills
- Information/Knowledge Sharing
- Judgment
- Listening
- Planning/Priority Setting
- Problem Solving
- Team Player
- Time Management
- Written/Oral Communication & Organizational Skills
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
About Horizon Blue Cross Blue Shield of New Jersey
Sourced by ZipRecruiter
Industry
Insurance services
Company size
5,001 - 10,000 Employees
Headquarters location
Newark, NJ, US
Year founded
1932