Field-Based Care Manager III – Health Plan Support

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

Benefits offered by this job

Comprehensive health benefits

Retirement plans

Generous PTO

Incentive plans

Wellness programs

Tuition reimbursement

Paid volunteer time off

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a field-based case manager to assess and coordinate care for members, collaborating with families and clinicians to ensure appropriate services. In this role you will support discharge planning, resource utilization and outcomes within the plan's guidelines.

The candidate will have a health-related degree, 3–4 years of clinical experience, and experience in managed care or home care, with travel in the field as required.

Qualifications

• Bachelor degree in a health-related or behavioral science field is required.
• 3–4 years broad clinical experience in healthcare settings.
• 3 years in home care, discharge planning or case management.
• 2+ years in the managed care industry preferred.
• Active, unrestricted NJ Social Work license is preferred.

Responsibilities

• Assess and manage members to ensure facilitation of health care services.
• Collaborate with member, family, physician and care team to coordinate services.
• Coordinate delivery of high quality, cost-effective care per clinical guidelines.
• Advocate for members to optimize resource utilization and outcomes.
• Document accurately per standards of practice and policies.
• Perform field-based and telephonic case management activities as assigned.

Skills

Clinical experience

Home health care

Case management

Managed care

Microsoft Office

Education

Bachelor degree in health-related or behavioral science field

NJ Social Work License (unrestricted)

Tools

Microsoft Office

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a field-based case manager to assess and coordinate care for members, collaborating with families and clinicians to ensure appropriate services. In this role you will support discharge planning, resource utilization and outcomes within the plan's guidelines.

The candidate will have a health-related degree, 3–4 years of clinical experience, and experience in managed care or home care, with travel in the field as required.