Specialty Care Manager I - Care Coordination & Transitions

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

Benefits offered by this job

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 Care Manager I – Specialty Programs to coordinate care for specialty populations using established guidelines. The role focuses on maximizing appropriate care and transition to the continuum of care, working with members, families, and healthcare teams.

Requirements include an RN license or a BA in social work/health/behavioral science, with a graduate degree preferred and at least 3 years of relevant experience.

Qualifications

• RN or BA in social work/health/behavioral science required.
• Graduate degree preferred in Social Work or Health & Behavioral Science.
• Minimum 3 years’ experience serving members with special needs.

Responsibilities

• Assess member’s clinical need against guidelines for specialty populations.
• Deliver high quality, cost-effective care based on model of care.
• Collaborate with member, family, physician and care team to meet needs.
• Advocate for member across sites to coordinate resources.
• Document according to practice standards and policies.
• Monitor utilization and outcomes to ensure appropriate care.

Education

RN license

Bachelor's degree in social work/health/behavioral science

Graduate degree in Social Work or Health and Behavioral Science

Tools

Microsoft Office

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a Care Manager I – Specialty Programs to coordinate care for specialty populations using established guidelines. The role focuses on maximizing appropriate care and transition to the continuum of care, working with members, families, and healthcare teams.

Requirements include an RN license or a BA in social work/health/behavioral science, with a graduate degree preferred and at least 3 years of relevant experience.