Care Management

Helping you care for your patients is a priority at Horizon NJ Health. Our Care Management program is dedicated to helping our members, adults and children, to get and to stay healthy.

Our Care Managers, nurses and social workers, will help members:

  • Coordinate services with their PCP, specialists, pharmacies and home care agencies
  • Schedule appointments, transportation and translation services
  • Educate themselves on how to manage their chronic health condition and answer questions about the member’s health and/or benefits
  • Provide resources for housing, behavioral health services, food, finance and education

Complex Case Management

Our Complex Case Management program at Horizon NJ Health is a team of nurses and social workers dedicated to helping those with complex medical conditions and help them get the care they need without going to the hospital when not needed.

Our case managers, nurses and social workers will:

  • Reach out to the member during their hospital stay and assist with any discharge planning
  • Work closely with the member to educate them about their chronic health condition
  • Coordinate services with the member’s PCP, specialist and any home services needed upon discharge

During the first 30 days at home, our case managers will:

  • Educate the member on the signs and symptoms of their condition, and how to avoid a repeat Emergency Room or inpatient hospital stays
  • Coordinate and manage the member’s care (working with the member, their family, and other health care providers)
  • Assist with behavioral health needs
  • Create a care plan for the member

Enroll members in programs

Both of these programs are part of the member’s benefits. If you have a member who can benefit from one of these program, please:

  • Fill out this form and send to the corresponding email for the member’s plan, OR
  • Call our Care Management Program at 1-800-682-9094 x89634, weekdays, 8 a.m. to 5 p.m., Eastern Time