Behavioral Health Clinician - Care Coordination

Horizon Blue Cross Blue Shield of New Jersey; Hopewell (NJ); Sur place; USD 71 000 - 94 000; Plein temps

Avantages offerts par ce poste

Comprehensive health benefits

Retirement Plans

Generous PTO

Incentive Plans

Wellness Programs

Paid Volunteer Time Off

Tuition Reimbursement

Résumé du poste

Horizon Blue Cross Blue Shield of New Jersey is seeking a Behavioral Health Case Manager to perform duties using established guidelines to ensure appropriate level of care and plan transitions across the continuum. This role includes coordination of services and advocacy for members.

Candidates should have at least two years of behavioral health clinical experience, NJ licensure eligibility, and strong collaboration with multidisciplinary teams in a managed care setting.

Qualifications

• High School Diploma/GED required.
• Bachelor's 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.

Responsabilités

• Assesses patient's behavioral health clinical need against guidelines to ensure appropriate level of care for inpatient stay.
• Evaluates the necessity, appropriateness and efficiency of behavioral health medical services and procedures.
• Coordinates and assists in the plan for members.
• Monitors and coordinates services outside of the network and outside the local area; negotiates fees as appropriate.
• Coordinates with patient, family, physician, hospital and other external customers regarding care from diagnosis to outcome.
• Coordinates the delivery of high quality, cost-effective care across the continuum of care.
• Monitors patients behavioral health medical care activities and outcomes for appropriateness and effectiveness.
• Advocates for member/family among sites to coordinate resource utilization.
• Encourages member participation in behavioral health case/disease management programs.
• Documents accurately and comprehensively per standards of practice and policies.
• Interacts with multidisciplinary teams to maintain continuity and efficiency.
• Understands fiscal accountability and its impact on resource utilization.
• Evaluates care by problem solving, analyzing variances and participating in quality improvement.
• Completes other assigned functions as requested by management.

Connaissances

Analytical

Compassion

Interpersonal Skills

Judgment

Listening

Planning

Priority Setting

Problem Solving

Team Player

Time Management

Written & Oral Communication

Formation

Bachelor's degree preferred

Outils

MS Office

Lotus Notes

Description du poste

Horizon Blue Cross Blue Shield of New Jersey is seeking a Behavioral Health Case Manager to perform duties using established guidelines to ensure appropriate level of care and plan transitions across the continuum. This role includes coordination of services and advocacy for members.

Candidates should have at least two years of behavioral health clinical experience, NJ licensure eligibility, and strong collaboration with multidisciplinary teams in a managed care setting.