Clinician

Job not on LinkedIn

🔥 8 hours 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

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 16%

What it means: the chance that no one is really hiring for this job.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

• Perform behavioral health duties using established guidelines to ensure appropriate level of care and plan transitions to the continuum of care. • Assess patients' behavioral health clinical needs against established guidelines and standards for medically appropriate inpatient level of care and length of stay. • Evaluate the necessity, appropriateness and efficiency of behavioral health medical services and procedures. • Coordinate and assist in implementing member care plans. • Monitor and coordinate out-of-network and out-of-area services, including internal fee negotiations when appropriate. • Coordinate with patients, families, physicians, hospitals and other external customers regarding care from diagnosis through outcome. • Coordinate high-quality, cost-effective care across the continuum using clinical practice guidelines. • Monitor behavioral health care activities and outcomes for appropriateness and effectiveness. • Advocate for members and families across care sites to coordinate resource utilization and evaluate services. • Encourage member participation and compliance in behavioral health case/disease management programs. • Document accurately and comprehensively according to practice standards and organizational policies. • Communicate with multidisciplinary teams by phone and/or in person to ensure continuity and efficiency. • Evaluate care, analyze variances, participate in quality improvement and enhance member outcomes. • Complete other assigned functions as requested by management.

🎯 Requirements

• High School Diploma/GED required. • Bachelor degree preferred or relevant experience in lieu of degree. • Requires a minimum of two (2) years behavioral health clinical experience. • Behavioral health experience, preferably in a managed care setting, strongly preferred. • Active Unrestricted NJ LCSW, LMFT, LPC or RN License. • Prefers proficiency in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes; prefers knowledge in the use of intranet and internet applications. • Prefers working knowledge of case/care management principles. • Prefers working knowledge of principles of utilization management. • Prefers basic knowledge of health care contracts and benefit eligibility requirements. • Prefers knowledge of hospital structures and payment systems. • Analytical skills. • Interpersonal and client relationship skills. • Judgment, listening, planning/priority setting, problem solving, teamwork, time management, written/oral communication and organizational skills.

🏖️ Benefits

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

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