About this opportunity
Horizon Blue Cross Blue Shield of New Jersey lists this Senior RN Appeals & Utilization Analyst opportunity in hopewell, New Jersey. Review the employer’s description below for duties, qualifications and application requirements.
Job description
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.
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Worksite address
hopewell, NJ, 08525, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.