DSNP Care Manager: Patient-Focused Case Navigator

100 Horizon Healthcare Services, Inc; Hopewell (NJ); On-site; USD 63,000 - 84,000; Full time

Benefits offered by this job

Health benefits

Retirement plans

Generous PTO

Tuition reimbursement

Wellness programs

Volunteer time off

Job summary

Horizon Blue Cross Blue Shield of New Jersey seeks a skilled case manager to assess and coordinate Dual Special Needs care, developing member-centered plans and ensuring appropriate, cost-effective services across the continuum.

The role requires at least 3 years of clinical experience, NJ licensure (SW/RN/LPN) or CSW, and strong organizational and communication abilities, with field-based or telephonic case management as needed.

Qualifications

• Broad clinical experience (3+ years) in home care, discharge planning, or case management.
• Active NJ SW/RN/LPN license or CSW.
• Familiarity with elderly frail population and managed care principles.

Responsibilities

• Assess clinical needs against guidelines to ensure medically appropriate care.
• Evaluate necessity, appropriateness, and efficiency of services.
• Develop and assist in implementing individualized plan of care.
• Coordinate with patient, family, physician, hospital and external parties.

Skills

Clinical assessment

Case management

Organizational skills

Oral and written communication

Problem solving

Presentation skills

Education

Bachelor degree preferred or relevant experience

High School Diploma/GED required

Tools

Microsoft Office (Excel, Access, Word)

Job description

Horizon Blue Cross Blue Shield of New Jersey seeks a skilled case manager to assess and coordinate Dual Special Needs care, developing member-centered plans and ensuring appropriate, cost-effective services across the continuum.

The role requires at least 3 years of clinical experience, NJ licensure (SW/RN/LPN) or CSW, and strong organizational and communication abilities, with field-based or telephonic case management as needed.