Care Manager I, Specialty Programs — Elevate Patient Care

Horizon Blue Cross Blue Shield of New Jersey; Hopewell (NJ); Vor Ort; USD 71.000 - 94.000; Vollzeit

Benefits dieser Stelle

Comprehensive health benefits

Retirement Plans

Generous PTO

Incentive Plans

Wellness Programs

Paid Volunteer Time Off

Tuition Reimbursement

Zusammenfassung

Horizon Blue Cross Blue Shield of New Jersey is seeking a Care Manager I - Specialty Programs to perform care coordination, ensuring appropriate care levels and planning transitions to the continuum of care for specialty populations. Responsibilities include guiding interventions to optimize benefits and outcomes.

The role emphasizes collaboration with members, families, physicians and health teams to meet care needs and improve efficiency, with a focus on compliant and high-quality care

Qualifikationen

• RN license or a Bachelor's 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.

Aufgaben

• Assess members' clinical needs against established guidelines for specialty population-based members.
• Implement high-quality, cost-effective care based on a population model of care with clinical guidelines.
• Coordinate with member/family, physician and healthcare team to meet member needs and advocate across sites.

Kenntnisse

Organizational skills

Communication skills

PC skills

Problem solving

Driver's license

Ausbildung

RN license or BS in social work/health/behavioral science

Graduate degree preferred in SW or health/behavioral science

Jobbeschreibung

Horizon Blue Cross Blue Shield of New Jersey is seeking a Care Manager I - Specialty Programs to perform care coordination, ensuring appropriate care levels and planning transitions to the continuum of care for specialty populations. Responsibilities include guiding interventions to optimize benefits and outcomes.

The role emphasizes collaboration with members, families, physicians and health teams to meet care needs and improve efficiency, with a focus on compliant and high-quality care