Care Manager

Job not on LinkedIn

🔥 14 minutes ago

🦌 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 11%

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 to ensure services are medically appropriate. • 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 patients' medical care activities and outcomes across all sites of service. • Advocate for members and families across various 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 activities for the Dual Special Needs program.

🎯 Requirements

• High School Diploma/GED required. • Bachelor degree preferred or relevant experience in lieu of degree. • 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) years' experience in the health care delivery system/industry. • Active Unrestricted NJ SW/RN/LPN License or CSW 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. • Requires strong organizational skills. • Requires strong oral and written communication skills. • Requires good PC skills and the ability to utilize Microsoft Office applications (Excel, Access, Word, etc.) • Requires good problem solving and conflict resolution skills. • Requires good presentation skills. • Requires ability to work with limited daily supervision. • Requires a car with valid New Jersey State License and Insurance.

🏖️ Benefits

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