Care Manager

Job not on LinkedIn

🔥 7 minutes ago

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

💵 $63k - $84.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Horizon Connect @ Wall BCBSNJ

WebsiteLinkedInAll Job Openings

2 - 10 employees

⚕️ Healthcare Insurance

🏥 Healthcare

Healthcare Insurance • Healthcare

Horizon Connect @ Wall BCBSNJ is a LinkedIn presence or local program/office associated with Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ). Based on the name and context, it appears to be connected to Horizon BCBSNJ’s health insurance operations and local outreach or member/provider engagement in the Wall, NJ area. Publicly available information provided is limited and mostly LinkedIn site chrome rather than a company profile, so this description is conservative and based on the affiliation indicated by the name.

📋 Description

• Assesses patient's clinical needs against established guidelines and/or standards • Evaluates the necessity, appropriateness and efficiency of services provided • Develops, coordinates and assists in implementation of members- individualized plan of care • Coordinates with patient, family, physician, hospital and other external customers • Coordinates the delivery of high quality, cost-effective care • Monitors patient's medical care activities and outcomes for appropriateness and effectiveness • Advocates for the member/family among various sites • Documents accurately and comprehensively based on the standards of practice • Provides field based and/or telephonic case management activities specific to the Dual Special Needs program

🎯 Requirements

• Requires a High School diploma or GED • Bachelor's degree from an accredited college or university preferred • Requires a minimum of three (3) years broad clinical experience • Requires a minimum of three (3) years experience in home care, discharge planning, or case management • Preferably with the elderly frail population • Requires a minimum of three (3) year experience in the health care delivery system/industry • Active Unrestricted NJ SW/RN/LPN License Required • Requires strong knowledge of the standards of practice for case managers • Requires strong knowledge of managed care principles and concepts including Health Plan Effectiveness Data and Information Sheet (HEDIS) • Required knowledge of medical terminology • Prefers knowledge of managed care principles • Prefer experience with elderly frail population.

🏖️ Benefits

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