Care Manager

Job not on LinkedIn

🕒 July 30

🦌 Connecticut, New Jersey, +2 more states – Remote

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

💵 $63k - $84.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 50%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• Assess patients' clinical needs against established guidelines and/or standards • Evaluate the necessity, appropriateness, and efficiency of services provided • Develop, coordinate, and assist in implementing members' individualized plans of care • Coordinate with patients, families, physicians, hospitals, and other external customers regarding appropriateness of care from diagnosis to outcome • Coordinate high-quality, cost-effective care across the continuum using clinical practice guidelines • Monitor medical care activities and outcomes for appropriateness and effectiveness • Advocate for members and families across care sites to coordinate resource utilization and evaluate services • Document accurately and comprehensively according to standards of practice and organizational policies • Provide field-based and/or telephonic case management for the Dual Special Needs program • Perform daily local travel for this field-based position

🎯 Requirements

• High School diploma or GED required • Bachelor's degree from an accredited college or university preferred • Minimum of three (3) years broad clinical experience • Minimum of three (3) years experience in home care, discharge planning, or case management • Minimum of three (3) years experience in the health care delivery system/industry • Active Unrestricted NJ SW/RN/LPN License Required • Strong knowledge of the standards of practice for case managers • Strong knowledge of managed care principles and concepts including HEDIS • Knowledge of medical terminology • Strong organizational skills • Strong oral and written communication skills • Good PC skills and ability to utilize Microsoft Office applications (Excel, Access, Word, etc.) • Good problem solving and conflict resolution skills • Good presentation skills • Ability to work with limited daily supervision • Car with valid New Jersey State License and Insurance required

🏖️ Benefits

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