Care Specialist III – Field Based

Job not on LinkedIn

🕒 July 13

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

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

💵 $70.5k - $94.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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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 and case-manage members to facilitate health care services • Assist with implementation and facilitation of member services • Collaborate with members/families, physicians, and internal and external healthcare teams • Coordinate high-quality, cost-effective care according to member needs, program models, and clinical practice guidelines • Advocate for members/families across sites to coordinate resource utilization and evaluate services • Use the care management process to set priorities, plan, organize, and implement goal-directed interventions • Encourage member participation and compliance in case management programs • Document accurately and comprehensively according to practice standards and organizational policies • Communicate with members through face-to-face and/or telephonic contact • Evaluate care, solve problems, analyze variances, and participate in quality improvement • Provide field-based and/or telephonic case management activities • Perform other duties as assigned by management • Travel locally on a daily basis and potentially participate in on-call work

🎯 Requirements

• Bachelor degree required in a health related or behavioral science field • Minimum of three (3) to four (4) years broad clinical experience • Minimum of three (3) years experience in home care, discharge planning, or case management • Preferably experience with the elderly frail population • Minimum of two (2) years' experience in the managed care industry • Active unrestricted NJ SW License preferred; candidates with a restricted license will not be considered • Willingness and ability to undertake required local travel and possible on-call work • Strong knowledge of standards of practice for care managers • Ability to interview and assess members • Knowledge of caseload management and casework practices • Knowledge of human services principles for determining member eligibility for benefits and services • Ability to solve problems effectively and locate community resources • Knowledge of needs and service delivery systems for assigned caseload populations • 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 • Employees must live in New Jersey, New York, Pennsylvania, Connecticut, or Delaware

🏖️ Benefits

• Comprehensive health benefits (Medical/Dental/Vision) • Retirement Plans • Generous PTO • Incentive Plans • Wellness Programs • Paid Volunteer Time Off • Tuition Reimbursement • Meaningful work that directly improves lives • Mission-driven organization that values expertise, collaboration, and growth