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H
RN II, Field – Cumberland County
Horizon Connect @ Wall BCBSNJ. Assess members' clinical needs against established guidelines and standards .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in clinical assessment, care coordination, and member advocacy while ensuring compliance with established guidelines and standards. Proficient in utilizing case management principles and effective communication within multidisciplinary teams.
Highest-signal resume keywords
Active Unrestricted NJ RN LicenseClinical ExperienceCare Management PrinciplesUtilization Management PrinciplesProficiency in MS Office
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical AssessmentCare CoordinationIndividualized Care PlansQuality ImprovementDocumentation Standards
Soft Skills
AdvocacyProblem SolvingCommunicationMember Engagement
Tools & Technologies
Windows-Based SoftwareMS Office ProductsLotus Notes
Certifications & Qualifications
Associate's Degree in NursingBachelor's Degree in NursingAccredited Diploma Nursing School
Industry Keywords
Clinical Needs AssessmentCost-Effective CareMultidisciplinary TeamsMember ParticipationLocal Travel
About the role
Key responsibilities & impact- Assess members' clinical needs against established guidelines and standards
- Evaluate the necessity, appropriateness, and efficiency of services
- Develop, coordinate, and assist in implementing individualized member care plans
- Coordinate with patients, families, physicians, hospitals, and external customers
- Coordinate high-quality, cost-effective care across the continuum
- Monitor members' medical care activities and outcomes
- Advocate for members and families across care sites
- Encourage member participation and program compliance
- Document accurately and comprehensively according to standards and policies
- Communicate with multidisciplinary teams telephonically and/or in person
- Evaluate care, solve problems, analyze variances, and participate in quality improvement
- Complete other assigned functions as requested by management
Requirements
What you’ll need- Associate's or bachelor's degree (or higher) in nursing and/or accredited diploma nursing school
- Minimum of two (2) years clinical experience
- Active unrestricted NJ RN license required
- Proficiency in personal computers and supporting software in a Windows-based environment
- Proficiency with MS Office products (Word, Excel, PowerPoint) and Lotus Notes
- Working knowledge of case/care management principles
- Working knowledge of utilization management principles
- Requires a car with valid New Jersey State License and Insurance
- Daily local travel required
- Bi-lingual preferred
Benefits
Comp & perks- Comprehensive health benefits (Medical/Dental/Vision)
- Retirement Plans
- Generous PTO
- Incentive Plans
- Wellness Programs
- Paid Volunteer Time Off
- Tuition Reimbursement