Member-Centric Care Coordinator

100 Horizon Healthcare Services, Inc; Hopewell (NJ); On-site; USD 56,000 - 75,000; Full time

Benefits offered by this job

Comprehensive health benefits

Retirement Plans

Generous PTO Incentive Plans

Wellness Programs

Paid Volunteer Time Off

Tuition Reimbursement

Job summary

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, provide authorizations, document activities, and ensure timely follow-up while upholding clinical guidelines and member-centric care.

Strong communication, organizational skills, and proficiency with medical management systems and Microsoft Office

Qualifications

• High School Diploma or GED required.
• Prefers healthcare industry experience.
• Prefers at least 1 year experience in home care, discharge planning, or case management.
• Elderly frail population experience preferred.
• Experience in the managed care industry preferred.

Responsibilities

• Schedule and coordinate service needs identified in the member's plan of care.
• Assist members in finding healthcare professionals and coordinating services and authorizations.
• Assist with implementation and facilitation of services.
• Ensure timely member follow up.
• Interact with the member during telephonic contact and communicate effectively.
• Assist with placing calls to members and providers as needed.
• Coordinate delivery of high-quality, cost-effective care based on member needs.
• Document accurately according to standards of practice and policies.

Skills

Organizational skills

Written communication

Oral communication

PC skills

Microsoft Office

Problem solving

Presentation skills

Independent work

Education

High School Diploma/GED

Tools

Medical Management System

Microsoft Office

Excel

Access

Word

Job description

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, provide authorizations, document activities, and ensure timely follow-up while upholding clinical guidelines and member-centric care.

Strong communication, organizational skills, and proficiency with medical management systems and Microsoft Office