Senior Field-Based Care Manager

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

Benefits offered by this job

Comprehensive health benefits (Medical

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 seasoned case manager to support members in home care and discharge planning. You will coordinate services with the healthcare team, evaluate needs, and guide patients toward optimal, cost-effective outcomes.

The role requires 3–4 years of clinical experience, a Bachelor’s degree, and travel within the local region. NJ RN/SW license preferred; strong communication and documentation skills are essential.

Qualifications

• Bachelor degree is required.
• 3–4 years broad clinical experience.
• 3 years in home care, discharge planning, or case management.
• Preferably with elderly frail population.
• 2 years in the managed care industry preferred.
• Active NJ RN/SW license preferred (unrestricted).
• Local travel and possible on-call work specific to the managed long term support and services case management program.

Responsibilities

• Assist with implementation and facilitation of services to members.
• Collaborates with member/family, physician and healthcare team.
• Coordinates the delivery of high quality, cost-effective care based on the members' needs and the program model.
• Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided.
• Interacts with the member/family, physician and healthcare team.
• Utilizes the care management process to set priorities, plan, organize, and implement interventions that are goal directed.
• Encourages member participation and compliance in the case management program efforts.
• Utilizes program case management process for goal directed member/family care.
• Documents accurately and comprehensively based on the standards of practice and current organization policies.
• Interacts and communicates effectively with member during face to face and/or telephonic contact.
• Understands fiscal accountability and its impact on the utilization of resources, while proceeding to optimal self-care outcomes.
• Evaluates care by problem solving, analyzing variances and participating in the quality improvement program to enhance member outcomes.
• Provides field based and/or telephonic case management activities specific case management program.
• Performs duties as assigned by management.

Skills

Case management

Healthcare coordination

Communication skills

Microsoft Office

Travel flexibility

Education

Bachelor's degree

Active NJ RN/SW license preferred

Tools

Excel

Access

Word

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a seasoned case manager to support members in home care and discharge planning. You will coordinate services with the healthcare team, evaluate needs, and guide patients toward optimal, cost-effective outcomes.

The role requires 3–4 years of clinical experience, a Bachelor’s degree, and travel within the local region. NJ RN/SW license preferred; strong communication and documentation skills are essential.