Behavioral Health Clinician & Care Coordinator

Horizon Blue Cross Blue Shield of New Jersey; Parsippany-Troy Hills (NJ); On-site; USD 71,000 - 94,000; Full time

Benefits offered by this job

Comprehensive health benefits

Retirement plans

Generous PTO

Incentive plans

Wellness programs

Paid volunteer time off

Tuition reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a Behavioral Health Case Manager to evaluate and coordinate inpatient and continuum-of-care for members. You will assess needs, coordinate services, and advocate for appropriate utilization within both network and out-of-network contexts.

The role emphasizes collaboration with multidisciplinary teams, documentation accuracy, and ongoing quality improvement to enhance member outcomes and cost-effective care.

Qualifications

• High School Diploma/GED required or equivalent experience.
• Bachelor's degree preferred or relevant experience.
• Minimum two years behavioral health clinical experience.
• Behavioral health experience in managed care setting preferred.

Responsibilities

• Assesses patient's behavioral health needs against guidelines to ensure appropriate level of care for inpatient stay.
• Evaluates necessity and efficiency of behavioral health medical services.
• Coordinates and assists in plan implementation for members.
• Monitors care outside network and negotiates fees where appropriate.

Skills

Analytical

Compassion

Interpersonal Skills

Judgment

Listening

Planning

Problem Solving

Team Player

Time Management

Communication

Education

High School Diploma/GED

Bachelor's degree preferred or relevant experience

Two years behavioral health clinical experience

Behavioral health experience in managed care setting preferred

Tools

MS Office

Lotus Notes

Windows environment

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a Behavioral Health Case Manager to evaluate and coordinate inpatient and continuum-of-care for members. You will assess needs, coordinate services, and advocate for appropriate utilization within both network and out-of-network contexts.

The role emphasizes collaboration with multidisciplinary teams, documentation accuracy, and ongoing quality improvement to enhance member outcomes and cost-effective care.