Care Specialist III – Field Based

Job not on LinkedIn

🔥 0 minutes ago

🦌 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

👻 Ghost score 18%

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

🎯 Requirements

• Bachelor degree is required • Requires a minimum of three (3) to four (4) 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 • Prefers a minimum of two (2) years' experience in the managed care industry • Active Unrestricted NJ RN/SW License Preferred; candidates with a restricted license will not be considered • Requires local travel and possible on call work • Strong knowledge of the standards of practice for case managers • Strong knowledge of managed care principles and concepts including HEDIS • 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 • Horizon BCBSNJ 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