RN I, PCA/MDC/DSNP (Field RN - Camden County)

• 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

The RN Assessor plays a vital, member-facing role within Camden County, with a primary focus on Camden City and surrounding areas including Pensauken and Cherry Hill. This position is responsible for conducting in-home assessments for individuals requesting services such as Personal Preference Programs (PPP), medical daycare (adult and pediatric), and personal assistance programs. In this highly autonomous role, the RN Assessor manages their own schedule to meet a required 7-day turnaround for evaluations, completing approximately 14–16 member assessments per week. Assessments are conducted primarily in members’ homes and involve evaluating Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), including mobility, bathing, toileting, hygiene, meal preparation, and household tasks. These evaluations require both observation and interview-based data collection to determine members’ functional needs and level of support. The role is approximately 60% field-based and 40% remote, with administrative responsibilities including documentation, authorization completion, provider coordination, and scheduling follow-up visits. Based on assessment outcomes, the RN Assessor may also connect members to case management or long-term support services as appropriate. This position is ideal for a self-directed, organized RN who is comfortable working independently in the field while maintaining strong clinical judgment and documentation skills. What You'll Do Assesses patient's clinical need against established guidelines and/or standards to ensure that the services provided are medically appropriate to members needs and aligned with benefit structure. 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 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. Refers members to MLTSS when appropriate. Educates members on the availability of DSNP if appropriate. 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. Completes other assigned functions as requested by management. Performs duties as assigned by management. What You Bring Qualifications: Requires an associates or bachelors degree (or higher) in nursing and/OR accredited diploma nursing school. A minimum of two (2) years clinical experience is preferred Additional licensing, certifications, registrations: Active Unrestricted NJ RN License Required.