Managed Care Coordinator II — Case & UM Liaison

Horizon Blue Cross Blue Shield of New Jersey; Hopewell (NJ); On-site; USD 50,000 - 67,000; Full time

Benefits offered by this job

Comprehensive health benefits

Retirement plan

Paid time off

Incentive plans

Wellness programs

Tuition reimbursement

Volunteer time off

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a dedicated professional to support Clinical Operations. In this role you will liaise between members, physicians, delegates, operational business members and member service coordinators, providing leadership to non-clinical teams and handling escalated issues with professionalism.

You will review service requests, coordinate benefits, and assist with case management, utilization management, and onboarding of new staff.

Qualifications

• High School Diploma or GED required.
• 3–5 years customer service experience preferred.

Responsibilities

• Review service requests for completeness and coordinate data transfer.
• Initiate callbacks and correspondence to members and providers to verify benefits and treatment plans.
• Assist with onboarding and training of new Managed Care Coordinators I.

Skills

Customer service

Coordination

Education

High School Diploma/GED

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a dedicated professional to support Clinical Operations. In this role you will liaise between members, physicians, delegates, operational business members and member service coordinators, providing leadership to non-clinical teams and handling escalated issues with professionalism.

You will review service requests, coordinate benefits, and assist with case management, utilization management, and onboarding of new staff.