Care Manager I, Specialty Programs & Coordination

100 Horizon Healthcare Services, Inc; Hopewell (NJ); On-site; USD 71,000 - 94,000; Full time

Benefits offered by this job

Health benefits

Retirement plans

Paid time off

Incentive plans

Wellness programs

Paid Volunteer Time Off

Tuition reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a Care Manager I – Specialty Programs to coordinate care for specialty populations. The role emphasizes targeted interventions, utilization management, and collaboration with members, families, physicians, and care teams.

Strong clinical knowledge, exceptional communication, and organizational skills are required; RN license or relevant bachelor degree is essential, with 3+ years in member care settings.

Qualifications

• Requires RN license or Bachelor degree in social work, health or behavioral science.
• Graduate level degree in Social Work or Health and Behavioral Science preferred.
• Minimum of three (3) years’ experience serving members with special needs.

Responsibilities

• Assess member’s clinical need against guidelines for specialty populations.
• Implement high quality, cost-effective care based on population model.
• Coordinate with member/family, physician, and care team to meet needs.
• Advocate for member across sites to coordinate resource utilization.
• Plan interventions toward self-care and transition to independence.
• Document per standards and policies; participate in quality improvement.

Skills

Organizational skills

Oral and written communication

Problem solving

Conflict resolution

Education

RN license

Bachelor degree in social work, health or behavioral science

Graduate degree in Social Work or Health and Behavioral Science preferred

Tools

Microsoft Office

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a Care Manager I – Specialty Programs to coordinate care for specialty populations. The role emphasizes targeted interventions, utilization management, and collaboration with members, families, physicians, and care teams.

Strong clinical knowledge, exceptional communication, and organizational skills are required; RN license or relevant bachelor degree is essential, with 3+ years in member care settings.