Clinical Care Associate: Care Coordination

Horizon Blue Cross Blue Shield of New Jersey; Parsippany-Troy Hills (NJ); Presencial; USD 56.000 - 75.000; Jornada completa

Descripción de la vacante

Horizon Blue Cross Blue Shield of New Jersey is seeking a Clinical Care Associate to support field-based Care Managers and serve as the first point of contact for members seeking services or authorizations. You will coordinate care, schedule services, and communicate with members, providers, and the health care team to ensure a member-centric plan of care.

Ideal candidates have a High School Diploma or GED, healthcare experience, and familiarity with managed care concepts.

Formación

• High School Diploma/GED required.
• Healthcare industry experience preferred.
• 1 year in home care, discharge planning, or case management preferred (elderly frail population).
• Managed care industry experience preferred.

Responsabilidades

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

Conocimientos

Organizational skills

Oral and written communication

PC skills

Microsoft Office

Problem solving

Conflict resolution

Presentation skills

Independent work

Educación

High School Diploma/GED

Herramientas

Medical Management system

Microsoft Office

Descripción del empleo

Horizon Blue Cross Blue Shield of New Jersey is seeking a Clinical Care Associate to support field-based Care Managers and serve as the first point of contact for members seeking services or authorizations. You will coordinate care, schedule services, and communicate with members, providers, and the health care team to ensure a member-centric plan of care.

Ideal candidates have a High School Diploma or GED, healthcare experience, and familiarity with managed care concepts.