Disease Management Case Manager jobs in Newark, NJ

Disease Management Case Manager coordinates the overall interdisciplinary plan of care for a patient in a disease management program, from admission to discharge. Acts as a liaison between patient/family, employer and healthcare personnel to ensure necessary care is provided promptly and effectively. Being a Disease Management Case Manager responsibilities include but are not limited to documenting case progress, identifying health risks, and reporting the findings of the case study at appropriate intervals. Requires an associate's degree/bachelor's degree, and is licensed to practice nursing. Additionally, Disease Management Case Manager typically reports to a supervisor or manager. Disease Management Case Manager's years of experience requirement may be unspecified. Certification and/or licensing in the position's specialty is the main requirement. (Copyright 2024 Salary.com)

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Field Care Specialist III-Medicaid Care Case and Disease Management-Essex/Hudson
  • Horizon Blue Cross Blue Shield of New Jersey
  • Newark, NJ FULL_TIME
  • Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware

    Job Summary:

    This field based position is accountable for the assessment and case management of members to ensure facilitation of health care services.Responsibilities:
    • Assist with implementation and facilitation of services to members in the program.

    • Collaborates with member/family, physician and all members of the healthcare team, internal and external to this organization.

    • Coordinates the delivery of high quality, cost-effective care based on the members' needs and the program model supported by clinical practice guidelines established by the plan.

    • 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.

    Disclaimer:
    This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

    Education/Experience:
    • High School Diploma/GED required.

    • Requires a minimum of three (3) to four (4) years broad clinical experience.

    • Requires a minimum of three (3) years experience in home care, discharge planning, or case management. Preferably with the elderly frail population.

    • Requires a minimum of two (2) years' experience in the managed care industry.

    Additional licensing, certifications, registrations:
    • Active Unrestricted NJ RN/SW License Preferred. Candidates with a restricted license will not be considered.

    • Requires local travel and possible on call work specific to the managed long term support and services case management program.

    Knowledge:
    • Requires strong knowledge of the standards of practice for case managers.

    • Requires strong knowledge of managed care principles and concepts including Health Plan Employer Data and Information Sheet (HEDIS).

    Skills and Abilities:
    • Requires strong organizational skills.

    • Requires strong oral and written communication skills.

    • Requires good PC skills and the ability to utilize Microsoft Office applications (Excel, Access, Word, etc.)

    • Requires good problem solving and conflict resolution skills.

    • Requires good presentation skills.

    • Requires ability to work with limited daily supervision.

    Travel:
    • This is a field based position, daily local travel is required.

    Salary Range:

    $68,500 - $91,665

    This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:

    • Comprehensive health benefits (Medical/Dental/Vision)

    • Retirement Plans

    • Generous PTO

    • Incentive Plans

    • Wellness Programs

    • Paid Volunteer Time Off

    • Tuition Reimbursement

    Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

     

  • 2 Days Ago

1
Field RN II-Medicaid-Care, Case and Disease Management- Essex/Hudson NJ Counties
  • 100 Horizon Healthcare Services, Inc
  • Newark, NJ FULL_TIME
  • Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware Job Summary: This position is responsible for performing RN duties using established guidelines to ens...
  • 15 Days Ago

1
Field Care Specialist III-Medicaid Care Case and Disease Management-Essex/Hudson County
  • 100 Horizon Healthcare Services, Inc
  • Newark, NJ FULL_TIME
  • Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware Job Summary: This field based position is accountable for the assessment and case management of member...
  • 15 Days Ago

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Field RN II-Medicaid-Care, Case and Disease Management- Essex/Hudson NJ Counties
  • Horizon Blue Cross Blue Shield of New Jersey
  • Newark, NJ FULL_TIME
  • Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or DelawareJob Summary:This position is responsible for performing RN duties using established guidelines to ensur...
  • 28 Days Ago

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Case Manager RN - Case Management - FT/Days
  • RWJBarnabas Health
  • Livingston, NJ FULL_TIME
  • JOB SUMMARY:The Nurse Case Manager coordinates the healthcare needs of patients in the hospital by collaborating with members of the interdisciplinary Patient Care Team and the Primary Care Physician ...
  • 4 Days Ago

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Intensive Case Management Supervisor
  • International Rescue Committee
  • Elizabeth, NJ FULL_TIME
  • Requisition ID: req37903Job Title: Intensive Case Management SupervisorSector: Social WorkEmployment Category: RegularEmployment Type: Full-TimeCompensation: USD 66,060.00 - 69,170.00 SalaryLocation: ...
  • 10 Days Ago

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0 Disease Management Case Manager jobs found in Newark, NJ area

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Chronic Disease Management Health Coach (Remote)
  • Vesta Healthcare
  • New York, NY
  • Nice to meet you, we're Vesta Healthcare. Vesta Healthcare is a specialized medical group focused today on aging adults ...
  • 3/28/2024 12:00:00 AM

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PCP II (Full- Time/Day Float)
  • Carepoint Health
  • Bayonne, NJ
  • About Us CarePoint Health is one of New Jersey's leading health care systems comprised of three long-standing and highly...
  • 3/28/2024 12:00:00 AM

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Breast Imaging Radiologist
  • CarePoint Health Management Associates
  • Bayonne, NJ
  • CarePoint Health is one of New Jerseys leading health care systems comprised of three long-standing and highly-regarded ...
  • 3/28/2024 12:00:00 AM

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Student Clinical Nurse (Per diem, Varied shift)
  • CarePoint Health
  • Jersey City, NJ
  • About Us: CarePoint Health is one of New Jerseys leading health care systems comprised of three long-standing and highly...
  • 3/27/2024 12:00:00 AM

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Certified Nurse Assistant
  • CarePoint Health
  • Hoboken, NJ
  • About Us: CarePoint Health is one of New Jerseys leading health care systems comprised of three long-standing and highly...
  • 3/25/2024 12:00:00 AM

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CNA/PCT (Part-time, Evening shift)
  • CarePoint Health
  • Jersey City, NJ
  • About Us: CarePoint Health is one of New Jerseys leading health care systems comprised of three long-standing and highly...
  • 3/25/2024 12:00:00 AM

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CNA/PCT (Part-time, Night shift)
  • CarePoint Health
  • Jersey City, NJ
  • About Us: CarePoint Health is one of New Jerseys leading health care systems comprised of three long-standing and highly...
  • 3/25/2024 12:00:00 AM

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General Imager Radiologist-Per Diem
  • CarePoint Health Management Associates
  • Hoboken, NJ
  • CarePoint Health is one of New Jerseys leading health care systems comprised of three long-standing and highly-regarded ...
  • 3/24/2024 12:00:00 AM

Newark (/ˈnjuːərk/,[24] locally /njʊərk/)[25] is the most populous city in the U.S. state of New Jersey and the seat of Essex County.[26] As one of the nation's major air, shipping, and rail hubs, the city had a population of 285,154 in 2017, making it the nation's 70th-most populous municipality, after being ranked 63rd in the nation in 2000. Settled in 1666 by Puritans from New Haven Colony, Newark is one of the oldest cities in the United States. Its location at the mouth of the Passaic River (where it flows into Newark Bay) has made the city's waterfront an integral part of the Port of New...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Disease Management Case Manager jobs
$89,787 to $104,011
Newark, New Jersey area prices
were up 1.6% from a year ago

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Our medical management team works closely with Member Services to ensure members understand their coverage, network structure and potential costs in relation to their health needs.
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