Remote RN Case Manager Position Available In Mercer, New Jersey

Remote RN Case Manager BayLeaf HR Solutions Pennington, NJ Job Details Temporary | Full-time $38•$40 an hour 1 day ago Benefits Health savings account Relocation assistance Health insurance Tuition reimbursement Paid time off Parental leave Employee assistance program Employee discount Referral program Retirement plan Qualifications Microsoft PowerPoint Microsoft Word Largest number of patients managed simultaneously as a nurse case manager (11-20 patients) Nursing experience (3-5 years) Care plan evaluation Nursing Microsoft Excel Medication administration Nurse case manager experience (11-15 years) Managed care RN License Nursing experience (More than 20 years) Nurse case manager experience (16-20 years) Nurse case manager experience (3-5 years) Nurse case manager experience (1-2 years) Mid-level Windows Practicing as a nurse case manager Palliative care expertise Nurse case manager experience (6-10 years) Clinical case management experience (6-10 years) Clinical case management Managing patients as a nurse case manager Clinical case management experience (3-5 years) Bachelor’s degree Clinical case management experience (11-15 years) Clinical case management experience (1-2 years) Largest number of patients managed simultaneously as a nurse case manager (1-5 patients) Bachelor of Science in Nursing Nursing experience (11-15 years) Largest number of patients managed simultaneously as a nurse case manager (More than 20 patients) Clinical case management experience (More than 20 years) Nursing experience (1-2 years) Medication management Nurse case manager experience (More than 20 years) Patient assessment visits Clinical case management experience (16-20 years) Managing patient records Associate’s degree Associate Degree in Nursing 2 years Nursing experience (16-20 years) Largest number of patients managed simultaneously as a nurse case manager (6-10 patients) Physical assessments Nursing experience (6-10 years) Home health safety assessments Nursing Nurse Licensure Compact (NLC) Time management

Full Job Description Job Title:

Remote RN•

Case Manager Company:

Horizon Blue Cross Blue Shield of New Jersey Location:

1700 American Blvd, Pennington, NJ 08534 (First & last day onsite; mostly remote)

Start Date:

July 14, 2025

Contract Length:

6

Months Schedule:

Monday•Friday | 8:00 AM•5:00 PM |

Full-Time Pay:

$40/hr on w2

Position Overview:

Horizon BCBS is seeking a Registered Nurse (RN) for a mostly remote Prior Authorization role. This RN will ensure the appropriate level of care through case review, coordination, and transition planning while adhering to clinical guidelines and healthcare regulations. First and last day will be onsite; remainder of the role is remote.

Key Responsibilities:

Review and assess member care needs against clinical guidelines Evaluate the medical necessity, efficiency, and appropriateness of care Manage care transitions and coordinate services both in and out of network Monitor utilization and effectiveness of treatment plans across care continuum Serve as an advocate and resource for members and their families Participate in quality improvement and reporting initiatives Mentor new RN team members as needed Maintain accurate documentation per company policies and nursing standards Handle 10-35 prior authorization cases daily, depending on team demand

Qualifications:

Education:

Associate’s or Bachelor’s Degree in Nursing OR Diploma from an accredited nursing school

Experience:

Minimum 2 years of clinical nursing experience Minimum 3 years of experience in healthcare delivery system Minimum 2 years of healthcare payer or managed care experience

License:

Active NJ RN License or Compact State License (Required)

Training:

2 weeks of training with mentor support and live case handling

Skills & Knowledge:

Knowledge of case/care/disease management best practices Familiarity with hospital systems, health plan benefits, and care coordination Proficiency in Windows-based systems (MS Word, Excel, PowerPoint, Lotus Notes) Effective communication, time management, planning, and judgment skills Strong adaptability, compassion, and analytical thinking

Additional Notes:

Must be based in NJ, NY, PA, CT, or DE and available for on-site equipment pickup No PTO preferred during the assignment Remote work starts after equipment is picked up and onboarding is completed #RemoteRNJobs #CaseManagementNurse #UtilizationReviewRN #HorizonBCBSJobs #NurseReviewer #ManagedCareNursing #PriorAuthNurse #TelehealthRN #HealthcareRemoteJobs #

NJRNJobs Job Types:

Full-time, Temporary Pay:

$38.00•$40.00 per hour Expected hours: 40 per week

Benefits:

Employee assistance program Employee discount Health insurance Health savings account Parental leave Referral program Relocation assistance Retirement plan Tuition reimbursement

Schedule:

8 hour shift Day shift Monday to

Friday Work Location:

On the road