Care Manager

Job not on LinkedIn

🔥 0 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

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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 standards to ensure medically appropriate services • Evaluate the necessity, appropriateness, and efficiency of services provided • Develop, coordinate, and assist with implementation of individualized member care plans • Coordinate with patients, families, physicians, hospitals, and external customers from diagnosis to outcome • Coordinate high-quality, cost-effective care across the continuum using clinical practice guidelines • Monitor medical care activities and outcomes across sites of service • Advocate for members and families by coordinating resource utilization and evaluating services • Document accurately and comprehensively according to practice standards and organizational policies • Provide field-based and telephonic case management for the Dual Special Needs program

🎯 Requirements

• High School Diploma/GED required • Bachelor degree preferred, or relevant experience in lieu of degree • 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 or CSW required • Strong knowledge of case management standards of practice • 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 use Microsoft Office applications, including Excel, Access, and Word • Good problem-solving and conflict-resolution skills • Good presentation skills • Ability to work with limited daily supervision • Daily local travel required • 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