BH Clinician

Horizon Connect @ Wall BCBSNJ

. Assess patients' behavioral health clinical needs against established guidelines and standards to determine medically appropriate level of care and inpatient length of stay.

Posted 10/5/2026full-timeRemote • New Jersey • United StatesJuniorMid-Level💰 $70,500 - $94,395 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in behavioral health clinical assessment, care coordination, and resource utilization while ensuring compliance with established guidelines. Proficient in communication and collaboration with multidisciplinary teams to enhance patient outcomes and advocate for member needs.

Highest-signal resume keywords

Behavioral Health Clinical ExperienceActive Unrestricted NJ LCSW, LMFT, LPC or RN LicenseCare Management PrinciplesUtilization Management PrinciplesAnalytical and Problem-Solving Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Behavioral Health AssessmentCare CoordinationResource UtilizationQuality ImprovementDocumentation Standards

Soft Skills

Interpersonal SkillsJudgmentListening SkillsTime ManagementOrganizational Skills

Tools & Technologies

MS Office ProductsLotus NotesWindows Based Environment

Certifications & Qualifications

High School Diploma/GEDBachelor Degree PreferredLCSW LicenseLMFT LicenseLPC LicenseRN License

Industry Keywords

Managed Care SettingHealth Care ContractsBenefit Eligibility RequirementsHospital StructuresPayment Systems

About the role

Key responsibilities & impact

Assess patients' behavioral health clinical needs against established guidelines and standards to determine medically appropriate level of care and inpatient length of stay.
Evaluate the necessity, appropriateness, and efficiency of behavioral health medical services and procedures.
Coordinate and assist in implementing member care plans.
Monitor and coordinate out-of-network and out-of-area services, including internal fee negotiations when appropriate.
Coordinate with patients, families, physicians, hospitals, and external customers regarding care from diagnosis through outcome.
Coordinate high-quality, cost-effective care across the continuum using plan-established clinical practice guidelines.
Monitor behavioral health care activities and outcomes for appropriateness and effectiveness across sites of service.
Advocate for members and families across care settings to coordinate resource utilization and evaluate services.
Encourage member participation and compliance in behavioral health case/disease management programs.
Document accurately and comprehensively according to practice standards and organizational policies.
Communicate with multidisciplinary teams telephonically and/or in person to support continuity and efficiency.
Apply fiscal accountability to utilization of resources and self-care outcomes.
Evaluate care, solve problems, analyze variances, and participate in quality improvement programs.
Complete other assigned functions as requested by management.

Requirements

What you’ll need

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.
Active Unrestricted NJ LCSW, LMFT, LPC or RN License.
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 preferred.
Knowledge of intranet and internet applications preferred.
Working knowledge of case/care management principles preferred.
Working knowledge of principles of utilization management preferred.
Basic knowledge of health care contracts and benefit eligibility requirements preferred.
Knowledge of hospital structures and payment systems preferred.
Analytical, compassion, interpersonal and client relationship, judgment, listening, planning/priority setting, problem solving, team player, time management, written/oral communication, and organizational skills.

Benefits

Comp & perks

Comprehensive health benefits (Medical/Dental/Vision)
Retirement Plans
Generous PTO
Incentive Plans
Wellness Programs
Paid Volunteer Time Off
Tuition Reimbursement