Senior Managed Care Coordinator

Horizon Blue Cross Blue Shield of New Jersey; Parsippany-Troy Hills (NJ); On-site; USD 50,000 - 67,000; 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 Clinical Operations liaison to support the clinical operations function and act as a liaison between members, physicians, delegates, and case management teams. You will guide non-clinical staff, handle escalated issues, and coordinate benefits and care paths.

This role involves onboarding new coordinators, liaising with providers, and performing case management-related tasks.

Qualifications

• High School Diploma or GED required.
• 3-5 years customer service experience.
• Medical certification translator education (Letter's Team, Medically Certified Spanish Translator only).
• Knowledge of medical terminology and regulatory standards.

Responsibilities

• Review service requests for completeness and transfer of non-clinical data.
• Prepare, document and route cases for clinical review.
• Coordinate benefits and treatment with members and providers.
• Assist with onboarding and training of new Managed Care Coordinators I.
• Act as liaison with providers, members and Care Managers.
• Perform other tasks as assigned by management.
• Assist members with finding providers and resolving questions regarding services.

Skills

Team Player

Analytical Skills

Interpersonal Skills

Education

High School Diploma/GED

Customer service experience (3-5 years)

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a Clinical Operations liaison to support the clinical operations function and act as a liaison between members, physicians, delegates, and case management teams. You will guide non-clinical staff, handle escalated issues, and coordinate benefits and care paths.

This role involves onboarding new coordinators, liaising with providers, and performing case management-related tasks.