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

This position is responsible for performing RN duties for the Primary Nurse population using established guidelines to ensure appropriate level of care, as well as, planning for the transition to the continuum of care and developing a member centric plan of care. Primary Nurses will outreach to high risk members and will work to engage members in preventative care opportunities & screenings when possible. This position will perform duties and types of care management as assigned by management. Serves as a mentor/trainer to new RN's and other staff as needed. Positions involving ASO accounts may require some travel for on-site availability.

What You'll Do

Assesses member's clinical need against established guidelines and/or standards to ensure that the services provided are medically appropriate to member's needs and aligned with the benefit structure.
Facilitates response to gaps in care and identified high risk members to appropriate settings of care for annual wellness visits including collaboration with treating provider.
Evaluates the necessity, appropriateness and efficiency of medical services and procedures provided for both acute and chronic health care needs.
Develops, coordinates and assists in implementation of individualized plan of care for members and identification of barriers towards Self-Management and optimal wellness.
Coordinates with members, 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 including transitional care.
Monitors member'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.
Encourages member participation and compliance in the case/disease management program efforts.
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.
Evaluates care by problem solving, analyzing variances and participating in the quality improvement program to enhance member outcomes.
Serves as mentor/trainer to new RN's and other staff as needed
Presents clinical cases during audits conducted by external review organizations.

What You Bring

Education/Experience:

Requires an associate's or bachelor's degree (or higher) in nursing and/or a health related field OR accredited diploma nursing school.
Requires a minimum of two (2) years clinical experience. Experience with both acute and chronic conditions preferred.
Requires a minimum of three (3) years' experience in the health care delivery system/industry.
Experience with health care payer experience strongly preferred.

Additional licensing, certifications, registrations:

Active Unrestricted RN License Required; NJ License Preferred
Requires a valid Driver's License and Insurance.

Knowledge:

Requires proficiency in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, and PowerPoint) and Microsoft Outlook. Prefers knowledge in the use of intranet and internet applications.
Requires working knowledge of case/care/disease management principles.
Requires working knowledge of operations of utilization, case and/or disease management processes.
Requires working knowledge of principles of utilization management.
Requires basic knowledge of health care contracts and benefit eligibility requirements.
Requires knowledge of hospital structures and payment systems.
Prefers understanding of fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes.

Skills and Abilities:

Bi-lingual proficiency preferred.
Adaptability/Flexibility
Analytical
Compassion
Information/Knowledge Sharing
Interpersonal & Client Relationship
Sound decision making
Active listening
Organization Planning/Priority Setting
Problem Solving/Critical Thinking
Team Player
Time Management
Written/Oral Communications

Why Horizon?

At Horizon, you’ll do meaningful work that directly improves lives—while being supported by a mission‑driven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too. If you are passionate about making an impact, we’d love to hear from you!

Salary Range:

$79,100 - $105,945

This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:

Comprehensive health benefits (Medical/Dental/Vision)
Retirement Plans
Generous PTO
Incentive Plans
Wellness Programs
Paid Volunteer Time Off
Tuition Reimbursement

Disclaimer:

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

About the company

Horizon NJ Health is a not-for-profit health insurer serving New Jersey. It offers a range of health insurance products for individuals, families, and employers, including medical plans such as HMOs and Medicare coverage for eligible people. The company collects premiums from its members and uses the funds to pay for member care through a network of doctors, hospitals, and healthcare providers. Any excess revenue is reinvested into the company to improve benefits and services for members, rather than distributing profits to shareholders. Horizon BCBSNJ holds a large market share in New Jersey and aims to provide access to comprehensive, affordable health coverage through a broad provider network. Its goal is to deliver reliable health insurance coverage and dependable care options that meet the needs of its members throughout the state.

Company Size

1,001-5,000

Company Stage

N/A

Total Funding

N/A

Headquarters

Newark, New Jersey

Founded

1932

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Simplify's Take

What believers are saying

HealthEZ targets 50-2,000-employee employers, opening a larger self-funded market by 2027.
KFF reported 67% of workers are already in self-funded plans, boosting demand.
Horizon cut 242 jobs by April 26, 2026, reducing overhead during margin pressure.

What critics are saying

CVS exits Horizon NJ Health on April 30, 2026, disrupting prescriptions for 800,000 members.
New Jersey's November 2025 $100 million settlement proved billing controls failed under state scrutiny.
If pharmacy and provider defections compound, Medicaid margins collapse and Horizon loses state-plan relevance.

What makes Horizon NJ Health unique

HealthEZ TPA, launching January 1, 2027, pairs Horizon network discounts with self-funded flexibility.
Horizon NJ Health serves 800,000+ Medicaid members, giving unmatched New Jersey contracting leverage.
Its non-profit structure and state-specific brand still anchor broker trust in New Jersey.

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Benefits

Health Insurance
Dental Insurance
Vision Insurance
401(k) Retirement Plan
Unlimited Paid Time Off
Wellness Program
Tuition Reimbursement

Company News

ROI-NJ

Oct 22nd, 2026

Horizon Blue Cross agrees to purchase Summit Health physician group.

Horizon Blue Cross agrees to purchase Summit Health physician group. John Harrington(Newark) October 22, 2026 Horizon Blue Cross Blue Shield of New Jersey, the state's largest and oldest health insurer, has agreed to buy physician group Summit Health's New Jersey operations, including CityMD urgent care locations in the state. Financial terms were not disclosed, though some media outlets reported a purchase price of $1 billion. "Horizon Mutual Holdings regularly reviews opportunities in the marketplace that advance our mission, benefit our members and support our long-term goals. To further those objectives, we have entered into an agreement to acquire Summit Health New Jersey, including the New Jersey CityMD sites, subject to regulatory review," a spokesperson for Horizon Mutual Holdings told ROI-NJ. "We are excited by the opportunity to preserve access to high quality care for all of Summit Health's patients, improve healthcare quality and affordability for our members, and to support the continued independence of Summit Health's physicians and clinicians for the benefit of New Jerseyans." The deal is subject to regulatory review and financial terms were not disclosed. Summit, a multispecialty health care system, operates more than 120 locations across New Jersey, New York and Connecticut, while CityMD operates more than 180 urgent care centers across the three states. Should the purchase pass regulatory muster, it would be Horizon Blue Cross Blue Shield's biggest deal since a 2020 state law allowed it to convert to a nonprofit mutual holding company from a health services corporation. The restructuring was effective Nov. 1, 2022. Horizon acquired HealthEZ from private equity firm ABRY Partners for $360 million on Jan. 1, 2025, its first-ever acquisition, as part of a broader push into the third-party administrator space. HealthEZ, founded in Minneapolis in 1982, serves employers, providers and brokers across multiple states. The move follows Horizon's 2022 reorganization from a not-for-profit health services corporation into a nonprofit mutual holding company under New Jersey law, which allowed the insurer to pursue acquisitions and invest more heavily in new programs and technology Summit was formed by the 2019 merger of Summit Medical Group and CityMD, which was acquired by Walgreens-backed VillageMD in early 2023 for $8.9 billion, while Cigna's health services subsidiary Evernorth took a minority stake. In 2025, private equity firm Sycamore Partners took Walgreens private in a deal that separated VillageMD, Summit Health and CityMD into a standalone company.

TAPinto

Oct 21st, 2026

Sussex County Community College celebrates grand opening of New outdoor Fitness Court(R) Studio.

Sussex County Community College celebrates grand opening of New outdoor Fitness Court(R) Studio. The SCCC Fitness Court Ribbon-Cutting Ceremony brought together College leadership, Board of Trustee members, County Commissioners, representatives from Horizon, and community members. Photo Credit: Kathleen Peterson By Kathleen Peterson Published October 21, 2026 at 7:03 PM Sussex County Community College (SCCC), in partnership with Horizon Blue Cross Blue Shield of New Jersey (Horizon) and National Fitness Campaign (NFC), celebrated the grand opening of its new outdoor Fitness Court(R) Studio with a ribbon-cutting ceremony on Thursday, October 15. The new facility provides students, faculty, staff, and Sussex County residents with free access to an innovative outdoor fitness experience designed to promote health, wellness, and physical activity. Located along College Hill Road on the upper SCCC campus, the Fitness Court(R) Studio is part of a nationwide initiative led by National Fitness Campaign to improve community health and expand access to outdoor exercise facilities. The ribbon-cutting ceremony brought together College leadership, Board of Trustee members, County Commissioners, representatives from Horizon, and community members to celebrate the addition of this new wellness resource. Get local news you can trust in your inbox. Dr. Cory Homer, President of Sussex County Community College, welcomed attendees and emphasized the importance of providing opportunities that support healthy lifestyles both on campus and throughout the community. "We are proud to introduce the new outdoor Fitness Court(R) as part of our commitment to supporting the health and well-being of our students and the broader community," said Dr. Homer. "This new space will encourage people of all fitness levels to stay active, connect with one another, and build healthy habits that can have a lasting impact on their lives." The ceremony also featured remarks from Herbert Yardley, Chair of the SCCC Board of Trustees; Jonathan Pearson, Executive Director of The Horizon Foundation for New Jersey and Corporate Social Responsibility at Horizon Blue Cross Blue Shield of New Jersey; Lorraine Hentz, Deputy County Administrator, Sussex County Division of Senior Services; and Sussex County Commissioner Chris Carney. "The fitness Court is to improve quality of life, and at the end of the day we want our community to achieve their best health. It's another tool we can provide to the community," stated Jonathan Pearson, Executive Director of The Horizon Foundation for New Jersey. "It expands free access to fitness and physical activity and breaks down barriers." After the ribbon-cutting, students from SCCC's Exercise Science program and athletes from the Baseball team demonstrated the Fitness Court's seven exercise stations, showing how the equipment supports a full-body workout. The demonstration highlighted the Fitness Court's versatility and its ability to accommodate individuals with different fitness levels and abilities. Designed for individuals ages 14 and older, the Fitness Court(R) uses body-weight exercises across seven stations to provide a complete workout. Each station targets different muscle groups, allowing users to build strength, improve flexibility, and enhance overall fitness. Users can modify exercises to meet individual needs, making the facility welcoming to both beginners and experienced fitness enthusiasts. The outdoor Fitness Court(R) Studio also includes a classroom area for group fitness activities, wellness programming, and educational experiences. The project reflects a shared commitment among SCCC, Horizon, and National Fitness Campaign to make exercise more accessible and encourage healthier communities throughout New Jersey. In addition to the outdoor equipment, visitors can download the free Fitness Court(R) App, which provides guided workouts, instructional videos, fitness challenges, and other resources. The app acts as a digital fitness coach, helping users make the most of their workouts. The Fitness Court(R) is free and available for students, employees, and community members. Editor's Note: This advertorial content is being published by TAPinto.net as a service for its marketing partners. For more information about how to market your business or nonprofit on TAPinto, please visit TAPintoMarketing.net or email [email protected]. The opinions expressed herein, if any, are the writer's alone, and do not reflect the opinions of TAPinto.net or anyone who works for TAPinto.net. TAPinto.net is not responsible for the accuracy of any of the information supplied by the writer. Get More TAPinto Local News on Google

Zoomus Marketing, LLC

Oct 3rd, 2026

Sussex County Community College to unveil new outdoor Fitness Court Studio.

Sussex County Community College to unveil new outdoor Fitness Court Studio. October 3, 2026 NEWTON - Sussex County Community College, Horizon Blue Cross Blue Shield of New Jersey and National Fitness Campaign are introducing a new outdoor Fitness Court Studio to promote health, wellness and physical activity among students and community members. Students, faculty, staff and community members are invited to attend the Fitness Court ribbon-cutting and grand opening at 4:00 p.m. on Thursday, October 15. The Fitness Court is located along College Hill Road on the upper campus of the college. The event will include a tour of the Fitness Court and an overview of its seven exercise stations and Studio classroom. The Fitness Court is part of a nationwide initiative led by National Fitness Campaign, which works to improve health outcomes and expand access to outdoor fitness opportunities across the United States. The college, Horizon and National Fitness Campaign developed the Fitness Court Studio to expand free access to workouts and create equitable access to exercise for communities across the region. The outdoor gym lets users leverage their own body weight for a complete workout using the seven exercise stations. "The commissioner board, along with senior services, is excited about another venture with Sussex County Community College to help with the health and fitness of our community," said Sussex County Commissioner Chris Carney. Designed for individuals ages 14 and older, the Fitness Court offers exercises that can be adapted for a range of abilities and fitness levels, allowing participants to exercise at their own pace. Sussex County Community College is one of the first 20 Campaign Partners building a network of Fitness Courts across the state with support from Horizon. Users may also download the free Fitness Court App, which serves as a "coach in your pocket" and provides guided workouts, instructional videos, fitness challenges and other resources. "We are proud to introduce the new outdoor Fitness Court(R) as part of our commitment to supporting the health and well-being of our students and the broader community," said Doctor Cory Homer, President of Sussex County Community College. "This accessible space will encourage people of all fitness levels to stay active, connect with one another, and build healthy habits that can have a lasting impact on their lives." "Investing in Fitness Courts is another way Horizon is working to empower our members to achieve their best health, while partnering with community organizations to build a healthier New Jersey," said Gary D. St. Hilaire, Horizon's Chairman and Chief Executive Officer. "As New Jersey's hometown health insurer, we're focused on making good health more affordable and more accessible. The opportunities created by our partnership with National Fitness Campaign build on Horizon's ninety-year history of supporting local organizations and improving the health of New Jersey's communities." "We are excited to have Sussex County Community College join us in the journey to improve health and wellness as we work to make a powerful and long-lasting impact on health outcomes and happiness by building healthy communities across America," said Mitch Menaged, founder of National Fitness Campaign. "The addition of the outdoor Fitness Court(R) Studio, along with digital wellness programming, demonstrates a tremendous commitment to the health and wellbeing within the community." Founded in San Francisco in 1979, National Fitness Campaign is a wellness consulting firm that provides programs and services to cities, schools and sponsors, with the goal of building a Fitness Court within a 10-minute bike ride of every American.

WM Trammell Company

Sep 9th, 2026

Merck ranks No. 9 nationally as 41 New Jersey companies make Forbes Best Employers list.

Merck ranks No. 9 nationally as 41 New Jersey companies make Forbes Best Employers list. Forbes released its 2026 Best Employers By State list. Forty-one companies from New Jersey earned spots. Merck & Co., headquartered in Kenilworth, claimed the No. 9 position on the national... Published Sep 9, 2026 2:40 PM EDT Forbes released its 2026 Best Employers By State list. Forty-one companies from New Jersey earned spots. Merck & Co., headquartered in Kenilworth, claimed the No. 9 position on the national rankings. This marks the eighth year for the annual study. Market research firm Statista surveyed more than 245,000 employees working for companies with at least 500 people within the United States. According to Patch, survey respondents from all 50 states and Washington, D.C., were asked how likely they were to recommend their employer on a scale of zero to 10. Workers evaluated their workplace based on criteria including wages and benefits, management style, company reputation, flexibility and career advancement opportunities. Merck & Co. is a Drugs & Biotechnology company founded in 1891. It employs more than 30,000 workers. The firm has a revenue of $65.5 billion with assets of $128.7 billion and profits at $8.9 billion. This company has had 82 appearances on Forbes annual list over the years. PSEG (Public Service Enterprise Group) took the No. 12 spot among the state's top performers. Sanofi came in at No. 13. Johnson & Johnson landed at No. 14. Horizon Blue Cross Blue Shield of New Jersey ranked No. 15 on the list. New Jersey Institute of Technology claimed the No. 23 position. Cooper University Health Care hit No. 24. University Hospital Newark followed at No. 28. Rowan University secured the No. 29 spot. Prudential Financial placed at No. 37. Virtua took No. 38. Rutgers University came in at No. 39. Church & Dwight ranked No. 43. Novartis landed at No. 45. Inspira Health took the No. 47 position, with Holman at No. 48. SHI International secured No. 49, while Compass International Holdings hit No. 50. William Paterson University placed at No. 53. The remaining companies on the list included St. Joseph's Healthcare System at No. 54, Crestron Electronics at No. 56, and Hackensack Meridian Health at No. 57. RWJBarnabas Health took No. 58. BAYADA Home Health Care at No. 59. Penn Medicine at No. 60. TD Bank ranked No. 63, Hamilton Township Public School District at No. 64, and Collabera at No. 66. Atlantic Health System landed at No. 67, the State of New Jersey at No. 68, and Panasonic at No. 69. Princeton University placed at No. 70. New Jersey Transit at No. 71. Cognizant at No. 76. FedEx took No. 77, Wells Fargo at No. 78, and J&J Snack Foods at No. 80. Novo Nordisk ranked No. 81, Burlington Stores at No. 83, Center For Family Services at No. 84, and Zoetis came in at No. 86.

Violet

Sep 1st, 2026

Violet recognized as a 2026 Fierce 50 honoree.

Violet recognized as a 2026 Fierce 50 honoree. Published on September 1, 2026 New York, NY - Sept. 1, 2026 - Violet has been named a 2026 Fierce 50 honoree by Fierce Pharma, Fierce Biotech and Fierce Healthcare. The Fierce 50 recognizes 50 individuals and organizations driving advancements in medicine, fostering innovation and shaping the future of biopharma and healthcare. "Now in its fourth year, the Fierce 50 continues to show that progress in this industry doesn't come from just one place," said Ayla Ellison, editor-in-chief of Fierce Life Sciences and Healthcare. "It's showing up in the lab, in executive leadership, in community clinics and in advocacy work that never makes headlines. Whether it's a biotech pushing a new therapy toward patients or a grassroots organization fighting for someone to get the care they need, these honorees remind us that impact takes a lot of different shapes. We're honored to celebrate all of them." Violet is incredibly grateful and proud of this honor. Violet actively serves over 100,000 providers on the Violet Platform to measure, improve, and showcase each provider's abiltiites delivering person-centered care. "It's been such a privilege seeing the industry continue moving in the right direction of prioritizing innovations that advance health equity via person-centered care. Whether it's a health plan looking to understand network performance or an individual provider seeking to improve their quality of care, Violet's technology is here to support you on making contributions to advance health equity across our country." - Gaurang Choksi, Founder & CEO at Violet Chosen by the editors of Fierce Pharma, Fierce Biotech and Fierce Healthcare, this year's Fierce 50 honorees reflect the breadth of talent and vision shaping the biopharma and healthcare industries today. From startups to established organizations, each has made a distinct contribution, whether by advancing scientific discovery, improving the health of communities, expanding access to care or reimagining how healthcare is delivered at a local level or on a global scale. To learn more about all of the honorees, click here: https://www.fiercepharma.com/collection/fierce-50-2026. To learn more about why Violet recieved this award, click here: https://www.fiercepharma.com/fierce-50/violet About Violet Health Violet is the first-ever platform improving quality of care by verifying providers for their capabilities of delivering person-centered care to diverse communities. Violet partners with health plans (e.g. United Healthcare, NHP, Horizon BCBS NJ, etc.) and care delivery organizations of all sizes (e.g. Northwell, One Medical, etc.) to: measure, improve, and showcase quality care. Violet leverages AI-powered analytics to gauge provider skills delivering tailored care across key patient populations and identifies areas for improvement. Violet then leverages clinical quality education to directly improve quality of care. Violet's early results show that person-centered care is enabling partners to both make large advancements growing their business and lowering total cost of care. About Fierce Pharma Fierce Pharma is the go-to destination for the news and trends shaping the industry. Its focus daily is on news about approved drugs and every aspect of pharma's operations as well as the people who move pharma forward. Its coverage also feeds longer-form content, podcasts and events. In staying on top of the news, its journalists have developed a loyal audience. Critically, Violet Services, Inc explain the news - often complicated technology or business maneuvers - and put it in context that brings it home for its readers and listeners in their work lives. About Fierce Biotech Fierce Biotech is the dominant B2B news brand for the industry. Every day, Violet Services, Inc track the companies, people and ideas reshaping biotech: from the discovery through clinical trials, approvals and commercialization, and the venture funding, partnerships, IPOs and M&A that power it all. That reporting fuels its long-form features, podcasts and events, where deal flow, data and on-the-ground insight come together into the fullest picture of where the industry is headed. About Fierce Healthcare At Fierce Healthcare, Violet Services, Inc deliver the news and analysis that healthcare can't afford to miss. Its newsroom serves the people building, running, and reshaping this industry: hospital executives and physicians, payers, policymakers, researchers and the entrepreneurs betting on what comes next. Wherever healthcare is being disrupted, financed, regulated, or reinvented, Violet Services, Inc is covering it, with breaking news, exclusive interviews and deep reporting that connects the dots between a boardroom decision and a patient's bedside experience. Join hundreds of providers and hospital networks receiving the latest health equity news.

Horizon NJ Health

Registered Nurse 2 Care Manager

About the job