Top 151 Care coordinator Jobs in Pennington Nj

Managed Care Coordinator I
Horizon Blue Cross Blue Shield of New Jersey —Hopewell, NJ
- $44,600 - $59,745 a year
- Full-time
- Writing skills
- High school diploma or GED
- Analysis skills
- Health insurance
- Dental insurance
4d
Managed Care Coordinator II
Horizon Blue Cross Blue Shield of New Jersey —Hopewell, NJ
- $50,100 - $67,095 a year
- Full-time
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance
3d
Cosmetic Patient Care Coordinator
Becker Plastic Surgery —Princeton, NJ
- $50,000 - $62,000 a year
- Full-time
- Private practice
- Surgery
- Patient care
- Paid holidays
- Health insurance
Quick Apply
Housing Care Coordinator
Catholic Charities - Diocese of Trenton —Trenton, NJ
- Full-time
- Mid-level
- Data entry
Hospice Registered Nurse Case Manager (RNCM)
Chandler Hall Health Svcs —Newtown, PA
- Full-time
- Nursing
- RN License
- Adults
Quick Apply
9d
Care Manager, Bergen, Passaic, and Surrounding Area
Peace Care Experts —New Jersey
- From $53 an hour
- Overtime
- Hybrid work
- Background check
- RN License
- Physical & Rehabilitation Medicine
- Paid training
- Mileage reimbursement
Quick Apply
Registered Nurse Case Manager – Field New Jersey
CVS Health —Trenton, NJ
- $66,575 - $142,576 a year
- Full-time
- Nursing
- RN License
- Mid-level
- Health insurance
- Dental insurance
10d
Concierge Coordinator RN - Medical Tourism - Hopewell - Full-Time - DAYS
Capital Health —Pennington, NJ
- $86,528.00 - $113,630.40 a year
- Full-time
- Bilingual
- Nursing
- RN License
- AD&D insurance
- Disability insurance
1d
Care Manager, Middlesex County
Peace Care Experts —New Jersey
- From $53 an hour
- Overtime
- Hybrid work
- RN License
- Physical & Rehabilitation Medicine
- Adults
- Paid training
- Mileage reimbursement
Quick Apply
1d
Hospice Clinical Liaison
Greenwood House Senior Healthcare —Township of Lawrence, NJ
- $70,000 a year
- Full-time
- Customer service
- Public speaking
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
1d
Field Case Management Nurse
Opus Medical —Trenton, NJ
- From $80,000 a year
- Full-time
- Bilingual
- Nursing
- RN License
- Health savings account
- Health insurance
Quick Apply
Behavioral Health Clinical Case Manager – Field in Atlantic and surrounding Counties, NJ
CVS Health —Trenton, NJ
- $66,575 - $142,576 a year
- Full-time
- Licensed Clinical Social Worker
- Mid-level
- Master's degree
- Health insurance
- Dental insurance
18h
Medical Billing and Collections Coordinator
Able Medical Transportation —Hillsborough, NJ
- $20 - $22 an hour
- Full-time
- Background check
- Management
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
1d
Home care coordinator/intake specialist
Alpha Sante Home Care —Doylestown, PA
- $24.64 - $26.00 an hour
- Part-time
- Bilingual
- Current TB test
- HIPAA
- Mileage reimbursement
- Health insurance
Quick Apply
8d
Enrollment Specialist (Mental Health) - Bilingual Spanish/English
TRI COUNTY CARE MANAGEMENT ORGANIZATION INC —Branchburg, NJ
- $44,000 - $47,000 a year
- Full-time
- Hybrid work
- Spanish
- English
- Mid-level
- AD&D insurance
- Paid holidays
Quick Apply
Registered Nurse Case Manager – Field New Jersey
CVS Health —Trenton, NJ
- $66,575 - $142,576 a year
- Full-time
- Nursing
- RN License
- Mid-level
- Health insurance
- Dental insurance
18h
Registered Nurse Case Manager – Field (Monmouth & Surrounding Counties, NJ)
CVS Health —Trenton, NJ
- $66,575 - $142,576 a year
- Full-time
- Nursing
- RN License
- Mid-level
- Health insurance
- Dental insurance
18h
RN Nurse Care Coordinator Group Home - Part Time - North/Central NJ
Interim HealthCare of South Plainfield, NJ —Somerset, NJ
- Part-time
- Experience working with individuals with developmental disabilities
- CPR Certification
- Nursing
Quick Apply
4d
Care Manager Registered Nurse - Field- Essex County, New Jersey
CVS Health —Trenton, NJ
- $66,575 - $142,576 a year
- Full-time
- Spanish
- Nursing
- Microsoft Outlook
- Health insurance
- Dental insurance
18h
Case Manager Registered Nurse - Field (Monmouth/Ocean) County, NJ
CVS Health —Trenton, NJ
- $66,575 - $142,576 a year
- Full-time
- Bilingual
- Nursing
- Microsoft Outlook
- Health insurance
- Dental insurance
18h

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Managed Care Coordinator I

Horizon Blue Cross Blue Shield of New Jersey -
Hopewell, NJ

Apply Now

Job Details

Full-time
$44,600 - $59,745 a year
4 days ago

Benefits

Health insurance
Dental insurance
Tuition reimbursement
Paid time off
Vision insurance
Volunteer time off
Retirement plan

Qualifications

Customer communication
Writing skills
High school diploma or GED
Medical terminology

Full Job Description

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 supports the Clinical Operations functions and acts as a liaison between Members, Physicians, Delegates, Operational Business members and Member Service Coordinators

What You'll Do

Responsibilities:

Performs review of service requests for completeness of information, collection and transfer of non-clinical data, and acquisition of structured clinical data from physicians/patients.
Prepare, document and route cases in appropriate system for clinical review. Initiates call backs and correspondence to members and providers to coordinate and clarify benefits.
Upon completion of inquiries initiate call back or correspondence to Physicians/Members to coordinate/clarify case completion.
Reviewing professional medical/claim policy related issues or claims in pending status.
Acts as liaison with providers, members and Care Managers.
Perform other relevant tasks as assigned by Management.

Utilization Management:

Upon collection of clinical and non-clinical information MCC can authorize services based upon scripts or algorithms used for pre-review screening.
Non Clinical staff members are not responsible for conducting any UM review activities that require interpretation of clinical information.
Handles initial screening for pre-certification requests from physicians/members via incoming calls or correspondence based on scripts and workflows, and under the oversight of clinical staff.

Case Management:

Assists members with finding providers, resolving problems and answering questions regarding anything from how to obtain services to how to file an appeal.
Makes outbound calls to in order to engage members in Case Management and to complete the necessary health assessment(s) (IHS/HRA, CNA/CMNA, MLTSS Elig Survey*.)
Educates members regarding preventive health activities and services.
Assists member to make appointments with their PCP, specialists, and/or transportation, etc. Handle PCP, demographic changes and/or new ID cards as requested by members.
Triage and distribute referrals from Member Services and incoming faxes from providers.
Reviews medical, dental and vision claims and address gaps in member's preventative care.
Review medical and administrative documentation for accuracy, grammar, and compliance with regulatory standards.
Perform initial screening of determination letters, ensuring clarity and compliance before distribution.
Make sound, timely decisions under the direction and supervision of a designated Supervisor.

What You Bring

Education/Experience:

High School Diploma/GED required.
Prefer 1-2 years customer service or medical support related position.

Knowledge and Skills:

Requires knowledge of medical terminology, Preferred – Medicaid CM.
Requires Good Oral and Written Communication skills.
Requires ability to make sound decisions under the direction of Supervisor.
Prefer knowledge of contracts, enrollment, billing & claims coding/processing.
Prefer knowledge Managed Care principles.
Prefer the ability to analyze and resolve problems with minimal supervision.
Prefer the ability to use a personal computer and applicable software and systems.
Team Player, Strong Analytical, Interpersonal Skills.

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:

$44,600 - $59,745

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.

Apply Now

Refine Your Search

care coordinator jobs in pennington nj

Managed Care Coordinator I

Managed Care Coordinator II

Cosmetic Patient Care Coordinator

Housing Care Coordinator

Hospice Registered Nurse Case Manager (RNCM)

Care Manager, Bergen, Passaic, and Surrounding Area

Registered Nurse Case Manager – Field New Jersey

Concierge Coordinator RN - Medical Tourism - Hopewell - Full-Time - DAYS

Care Manager, Middlesex County

Hospice Clinical Liaison

Field Case Management Nurse

Behavioral Health Clinical Case Manager – Field in Atlantic and surrounding Counties, NJ

Medical Billing and Collections Coordinator

Home care coordinator/intake specialist

Enrollment Specialist (Mental Health) - Bilingual Spanish/English

Registered Nurse Case Manager – Field New Jersey

Registered Nurse Case Manager – Field (Monmouth & Surrounding Counties, NJ)

RN Nurse Care Coordinator Group Home - Part Time - North/Central NJ

Care Manager Registered Nurse - Field- Essex County, New Jersey

Case Manager Registered Nurse - Field (Monmouth/Ocean) County, NJ

I want to receive the latest job alert for care coordinator in pennington nj

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