BH Clinician

Search Filters Location Time Type Division More Search for Jobs page is loaded 34 JOBS FOUND Jump to selected job details Housing Specialist locations Hopewell, NJ

• Remote posted on Posted Yesterday 2019-10977 BH Clinician locations Newark, NJ
• Remote posted on Posted Yesterday 2019-10969 RN II, Primary Nurse Care locations Hopewell, NJ
• Remote posted on Posted Yesterday 2019-10996 National Programs Analyst locations Newark, NJ
• Remote posted on Posted Yesterday 2019-10995 Supervisor, Clinical Ops locations Hopewell, NJ
• Remote posted on Posted Yesterday 2019-10994 Medical Policy Specialist II locations Newark, NJ
• Remote posted on Posted 2 Days Ago 2019-10963 Dir, AI CoE locations Newark, NJ posted on Posted 2 Days Ago 2019-11008 RN

I, PCA/MDC/DSNP

(Hudson County) locations Newark, NJ

• Mobile posted on Posted 2 Days Ago 2019-11006 RN

I, PCA/MDC/DSNP

• Passaic County locations Hopewell, NJ
• Mobile posted on Posted 2 Days Ago 2019-11005 Digital Products Reporting Manager locations Newark, NJ
• Remote posted on Posted 3 Days Ago 2019-11017 Business Analyst III locations Newark, NJ
• Remote posted on Posted 3 Days Ago 2019-10971 Self-Direction PPP Support Counselor locations Hopewell, NJ
• Mobile posted on Posted 3 Days Ago 2019-10978 Business Analyst II locations Newark, NJ
• Remote posted on Posted 6 Days Ago 2019-10967 Reporting Analyst II locations Newark, NJ
• Hybrid posted on Posted 6 Days Ago 2019-10788 Mgr, Actuarial III locations Newark, NJ
• Remote posted on Posted 6 Days Ago 2019-10972 Mgr, Property Management and Security locations Newark, NJ posted on Posted 7 Days Ago 2019-11015 Dir, Enterprise Applications locations Newark, NJ
• Hybrid posted on Posted 7 Days Ago 2019-10739 Special Investigations FEP Program Lead locations Newark, NJ
• Remote posted on Posted 8 Days Ago 2019-10912 Investigator II locations Newark, NJ
• Remote posted on Posted 8 Days Ago 2019-10802 Clinical Pharmacist locations Hopewell, NJ
• Remote posted on Posted 10 Days Ago 2019-10937 1 2 1
• 20 of 34 jobs Return to selected search result BH Clinician Apply locations Newark, NJ
• Remote time type Full time posted on Posted Yesterday job requisition id 2019-10969 Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health.

For over 90 years , we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. About the Role This position is responsible for performing behavioral health duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care. Performs duties and types of care management as assigned by management. What You'll Do Assesses patient's behavioral health clinical need against established guidelines and/or standards to ensure that the level of care and length of stay of the patient are medically appropriate for inpatient stay. Evaluates the necessity, appropriateness and efficiency of behavioral health medical services and procedures provided. Coordinates and assists in implementation of plan for members. Monitors and coordinates services rendered outside of the network, as well as outside the local area, and coordinates internally for negotiation of fees for such services as appropriate. Coordinates with patient, family, physician, hospital and other external customers with respect to the appropriateness of care from diagnosis to outcome. Coordinates the delivery of high quality, cost-effective care supported by clinical practice guidelines established by the plan addressing the entire continuum of care. Monitors patient's behavioral health medical care activities, regardless of the site of service, and outcomes for appropriateness and effectiveness. Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided. Encourages member participation and compliance in the behavioral health case/disease management program efforts. Documents accurately and comprehensively based on the standards of practice and current organization policies. Interacts and communicates with multidisciplinary teams either telephonically and/or in person striving for continuity and efficiency as the member is managed along the continuum of care. Understands fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes. Evaluates care by problem solving, analyzing variances and participating in the quality improvement program to enhance member outcomes. Completes other assigned functions as requested by management.

What You Bring Education/Experience:

High School Diploma/GED required. Bachelor degree preferred or relevant experience in lieu of degree. Requires a minimum of two (2) years behavioral health clinical experience. Behavioral health experience, preferably in a managed care setting, strongly preferred Additional licensing, certifications, registrations: Active Unrestricted NJ LCSW, LMFT, LPC or RN License.

Knowledge:

Prefers proficiency in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes; prefers knowledge in the use of intranet and internet applications. Prefers working knowledge of case/care management principles. Prefers working knowledge of principles of utilization management. Prefers basic knowledge of health care contracts and benefit eligibility requirements. Prefers knowledge of hospital structures and payment systems.

Skills and Abilities:

Analytical Compassion Interpersonal & Client Relationship Skills Judgment Listening Planning/Priority Setting Problem Solving Team Player Time Management Written/Oral Communication & Organizational Skills Travel:

For field based positions, travel required 100%. Why Horizon? At Horizon, you'll do meaningful work that directly improves lives—while being supported by a mission‑driven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too. If you are passionate about making an impact, we'd love to hear from you!

Salary Range:

$70,500

• $94,395 ​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 Disclaimer:

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. 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. 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. Search Filters Location Time Type Division More Search for Jobs page is loaded 34 JOBS FOUND Jump to selected job details Housing Specialist locations Hopewell, NJ

• Remote posted on Posted Yesterday 2019-10977 BH Clinician locations Newark, NJ
• Remote posted on Posted Yesterday 2019-10969 RN II, Primary Nurse Care locations Hopewell, NJ
• Remote posted on Posted Yesterday 2019-10996 National Programs Analyst locations Newark, NJ
• Remote posted on Posted Yesterday 2019-10995 Supervisor, Clinical Ops locations Hopewell, NJ
• Remote posted on Posted Yesterday 2019-10994 Medical Policy Specialist II locations Newark, NJ
• Remote posted on Posted 2 Days Ago 2019-10963 Dir, AI CoE locations Newark, NJ posted on Posted 2 Days Ago 2019-11008 RN

I, PCA/MDC/DSNP

(Hudson County) locations Newark, NJ

• Mobile posted on Posted 2 Days Ago 2019-11006 RN

I, PCA/MDC/DSNP

• Passaic County locations Hopewell, NJ
• Mobile posted on Posted 2 Days Ago 2019-11005 Digital Products Reporting Manager locations Newark, NJ
• Remote posted on Posted 3 Days Ago 2019-11017 Business Analyst III locations Newark, NJ
• Remote posted on Posted 3 Days Ago 2019-10971 Self-Direction PPP Support Counselor locations Hopewell, NJ
• Mobile posted on Posted 3 Days Ago 2019-10978 Business Analyst II locations Newark, NJ
• Remote posted on Posted 6 Days Ago 2019-10967 Reporting Analyst II locations Newark, NJ
• Hybrid posted on Posted 6 Days Ago 2019-10788 Mgr, Actuarial III locations Newark, NJ
• Remote posted on Posted 6 Days Ago 2019-10972 Mgr, Property Management and Security locations Newark, NJ posted on Posted 7 Days Ago 2019-11015 Dir, Enterprise Applications locations Newark, NJ
• Hybrid posted on Posted 7 Days Ago 2019-10739 Special Investigations FEP Program Lead locations Newark, NJ
• Remote posted on Posted 8 Days Ago 2019-10912 Investigator II locations Newark, NJ
• Remote posted on Posted 8 Days Ago 2019-10802 Clinical Pharmacist locations Hopewell, NJ
• Remote posted on Posted 10 Days Ago 2019-10937 1 2 1
• 20 of 34 jobs Return to selected search result BH Clinician Apply locations Newark, NJ
• Remote time type Full time posted on Posted Yesterday job requisition id 2019-10969 Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health.

For over 90 years , we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. About the Role This position is responsible for performing behavioral health duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care. Performs duties and types of care management as assigned by management. What You'll Do Assesses patient's behavioral health clinical need against established guidelines and/or standards to ensure that the level of care and length of stay of the patient are medically appropriate for inpatient stay. Evaluates the necessity, appropriateness and efficiency of behavioral health medical services and procedures provided. Coordinates and assists in implementation of plan for members. Monitors and coordinates services rendered outside of the network, as well as outside the local area, and coordinates internally for negotiation of fees for such services as appropriate. Coordinates with patient, family, physician, hospital and other external customers with respect to the appropriateness of care from diagnosis to outcome. Coordinates the delivery of high quality, cost-effective care supported by clinical practice guidelines established by the plan addressing the entire continuum of care. Monitors patient's behavioral health medical care activities, regardless of the site of service, and outcomes for appropriateness and effectiveness. Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided. Encourages member participation and compliance in the behavioral health case/disease management program efforts. Documents accurately and comprehensively based on the standards of practice and current organization policies. Interacts and communicates with multidisciplinary teams either telephonically and/or in person striving for continuity and efficiency as the member is managed along the continuum of care. Understands fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes. Evaluates care by problem solving, analyzing variances and participating in the quality improvement program to enhance member outcomes. Completes other assigned functions as requested by management.

What You Bring Education/Experience:

High School Diploma/GED required. Bachelor degree preferred or relevant experience in lieu of degree. Requires a minimum of two (2) years behavioral health clinical experience. Behavioral health experience, preferably in a managed care setting, strongly preferred Additional licensing, certifications, registrations: Active Unrestricted NJ LCSW, LMFT, LPC or RN License.

Knowledge:

Prefers proficiency in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes; prefers knowledge in the use of intranet and internet applications. Prefers working knowledge of case/care management principles. Prefers working knowledge of principles of utilization management. Prefers basic knowledge of health care contracts and benefit eligibility requirements. Prefers knowledge of hospital structures and payment systems.

Skills and Abilities:

Analytical Compassion Interpersonal & Client Relationship Skills Judgment Listening Planning/Priority Setting Problem Solving Team Player Time Management Written/Oral Communication & Organizational Skills Travel:

For field based positions, travel required 100%. Why Horizon? At Horizon, you'll do meaningful work that directly improves lives—while being supported by a mission‑driven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too. If you are passionate about making an impact, we'd love to hear from you!

Salary Range:

$70,500

• $94,395 ​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 Disclaimer:

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. 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. 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.