Care Coordination Associate - Member Support

Horizon Blue Cross Blue Shield of New Jersey; Hopewell (NJ); In loco; USD 56.000 - 75.000; Tempo pieno

Vantaggi offerti da questo lavoro

Comprehensive health benefits

Retirement Plans

Generous PTO

Incentive Plans

Wellness Programs

Paid Volunteer Time Off

Tuition Reimbursement

Descrizione del lavoro

Horizon Blue Cross Blue Shield of New Jersey is seeking a Clinical Care Associate to support field-based Care Managers (RN II and Care Specialist III) and serve as the first point of contact for members seeking services, authorizations, or provider information. The role coordinates services under supervision of the Care Manager and ensures timely, member-centric care.

You will help schedule care, coordinate services, and communicate with members, providers, and the care team while following

Competenze

• High School Diploma/GED required.
• Prefers healthcare industry experience.
• Prefers a minimum of one (1) year experience in home care, discharge planning, or case management. Preferably with the elderly frail population.
• Prefer a minimum of one (1) year experience in the managed care industry.

Mansioni

• Assist with scheduling and coordination of service needs identified in the member's Plan of Care.
• Assist with all aspects of the implementation and facilitation of services.
• Ensure timely member follow up and effective telephonic communication.
• Encourage member participation and compliance in the program.
• Coordinate delivery of high-quality, cost-effective care.
• Interact with the member/family, physician and healthcare team to plan and implement interventions.
• Provide member education to support health and well-being.
• Document accurately according to policy and standards.
• Provide telephonic assistance for program activities and resolve issues for members and field staff.

Conoscenze

Organizational skills

Communication

Problem solving

Presentation skills

Independent work

PC skills

Formazione

High School Diploma/GED

Strumenti

Medical Management system

Excel

Access

Word

Descrizione del lavoro

Horizon Blue Cross Blue Shield of New Jersey is seeking a Clinical Care Associate to support field-based Care Managers (RN II and Care Specialist III) and serve as the first point of contact for members seeking services, authorizations, or provider information. The role coordinates services under supervision of the Care Manager and ensures timely, member-centric care.

You will help schedule care, coordinate services, and communicate with members, providers, and the care team while following