Horizon Blue Cross Blue Shield of New Jersey is seeking a skilled Utilization Management RN to handle medical appeal cases, ensure timely processing, and maintain regulatory compliance (NCQA, URAC, NJ/Federal). The role includes mentoring staff, coordinating with legal, and supporting 24/7 on-call appeal coverage.
Qualifications include RN license, 2 years clinical experience, and 3 years in healthcare delivery. Bachelor’s in healthcare mgmt preferred or equivalent experience.
#J-18808-LjbffrSenior RN Appeals & Utilization Analyst in hopewell at Unknown Company
- Typical pay
- $71,760–$109,200
For context, most registered nurses earn between $71,760–$109,200 a year according to Bureau of Labor Statistics wage data. What this particular role pays is set by the employer — check the description above.
This position is listed as full time and onsite.