DSNP Care Manager

Vaga não está no LinkedIn

🕒 Novembro 2

🦌 Connecticut, New Jersey, +2 estados a mais – Remoto

🦌 Connecticut – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🔔 Pennsylvania – Remote

💵 $63.000 - $84.420 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

👻 Score fantasma 15%

O que significa: a chance de ninguém estar realmente contratando para esta vaga.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Por que essa pontuação:

• Aberta há 9 dias.
• As vagas desta empresa costumam ser preenchidas em 21 dias.

Candidatar-se

Encontrar Vagas Remotas Similares

Horizon Connect @ Wall BCBSNJ

SiteLinkedInTodas as Vagas

2 - 10 funcionários

⚕️ Seguro de Saúde

🏥 Saúde

Healthcare Insurance • Healthcare

Horizon Connect @ Wall BCBSNJ é uma presença no LinkedIn ou programa/escritório local associado ao Horizon Blue Cross Blue Shield de New Jersey (BCBSNJ). Com base no nome e no contexto, parece estar conectado às operações de seguro de saúde do Horizon BCBSNJ e ao alcance local ou envolvimento de membros/provedores na área de Wall, NJ. As informações disponíveis publicamente são limitadas e consistem principalmente na interface do site do LinkedIn em vez de um perfil da empresa, então essa descrição é conservadora e baseada na afiliação indicada pelo nome.

Descrição

• Assess members' clinical, functional, and psychosocial needs using established clinical guidelines and care management standards • Evaluate the medical necessity, appropriateness, and effectiveness of services provided • Develop, coordinate, and support implementation of individualized, member-centered care plans • Identify healthcare needs, barriers to care, and opportunities to improve outcomes • Coordinate care and services with members, families, physicians, hospitals, community organizations, and other healthcare providers • Ensure seamless care coordination across the continuum of care • Advocate for members and families to ensure access to appropriate services, programs, and community resources • Facilitate resource utilization and service coordination across multiple care settings • Provide field-based and telephonic case management services for SNP members • Monitor healthcare services and member outcomes regardless of the site of care • Track member progress and evaluate the effectiveness of interventions and care plans • Identify changes in member conditions and coordinate timely interventions • Maintain accurate, thorough, and timely documentation • Ensure adherence to care management guidelines, regulatory requirements, and quality standards • Support delivery of high-quality, cost-effective care guided by evidence-based clinical practice standards • Promote quality outcomes through ongoing assessment, monitoring, and follow-up

🎯 Requisitos

• High School Diploma or GED required • Minimum of three (3) years of broad clinical experience • Minimum of three (3) years of experience in home care, discharge planning, case management, or a related healthcare setting • Minimum of three (3) years of experience working within the healthcare delivery system • Active, unrestricted New Jersey license as one of the following: Registered Nurse (RN), Licensed Practical Nurse (LPN), Social Worker (SW), or Certified Social Worker (CSW) • Strong knowledge of case management standards and best practices • Strong understanding of managed care concepts and healthcare delivery systems • Knowledge of HEDIS measures and quality improvement principles • Strong knowledge of medical terminology • Understanding of care coordination, resource management, and member advocacy • Knowledge of community resources and support services available to vulnerable populations • Employees must live in New Jersey, New York, Pennsylvania, Connecticut, or Delaware

🏖️ Benefícios

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

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