Senior Field-Based Case Manager III

Horizon Blue Cross Blue Shield of New Jersey; Hopewell (VA); 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

Paid volunteer time off

Tuition reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a field-based Care Manager to assess and manage members to facilitate health care services. You’ll collaborate with members, families, physicians and the healthcare team to coordinate high-quality, cost-effective care guided by clinical practice guidelines, while advocating for the member and documenting all activities in accordance with policies.

You will travel locally, manage diverse case loads, and contribute to quality improvement

Qualifications

• Bachelor degree is required.
• Minimum 3–4 years broad clinical experience.
• Minimum 3 years in home care, discharge planning, or case management; elderly frail population preferred.
• Minimum 2 years in managed care industry preferred.

Responsibilities

• Assist with implementation and facilitation of services to members.
• Collaborates with member/family, physician and healthcare team.
• Coordinates delivery of high quality, cost-effective care per guidelines.
• Advocates for member/family across sites to coordinate resources.
• Interacts with member/family and care team; uses care management process.
• Encourages member participation and compliance in the program.
• Documents accurately per standards and policies.
• Performs duties as assigned by management.

Skills

Organizational skills

Communication skills

MS Office

Problem solving

Presentation skills

Independent work

Education

Bachelor degree

Tools

Excel

Access

Word

MS Office Suite

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a field-based Care Manager to assess and manage members to facilitate health care services. You’ll collaborate with members, families, physicians and the healthcare team to coordinate high-quality, cost-effective care guided by clinical practice guidelines, while advocating for the member and documenting all activities in accordance with policies.

You will travel locally, manage diverse case loads, and contribute to quality improvement