This position provides Rating & Underwriting services and support to the Sales team and is responsible for the production of rates for the 51+ markets. This position will support Rating & Underwriting services for Stop Loss products. Develops and issues proposal rates for group size 51+ and experience rated proposals. Develops and issues experience rated renewals for grou

The Risk Adjustment Vendor & Performance Analyst is responsible for supporting the management and administration of risk adjustment vendors and performance monitoring of those vendors and the overall risk adjustment department. This includes managing all data transferred to and from Risk Adjustment vendors as well as other external and internal areas related to establishi

This position will perform care management duties specifically targeting high risk members within Medicare Advantage/Commercial risk adjusted populations to enhance the deployment of risk adjustment tactics. This position will work closely with the Care Management and Risk Adjustment Management (RAM) teams, including the RAM Manager & RAM Business Analysts to assess the h

This position will perform care management duties specifically targeting high risk members within Medicare Advantage/Commercial risk adjusted populations to enhance the deployment of risk adjustment tactics. This position will work closely with the Care Management and Risk Adjustment Management (RAM) teams, including the RAM Manager & RAM Business Analysts to assess the h

Reporting to the Director of Corporate Development & Venture Investment, the Corporate Development and Venture Investment Analyst II will be a key contributor across enterprise investments and initiatives that support the Company's $100 million dollar alternative investment fund and revenue diversification opportunities. The role will work closely with deal leads, cross f

The Analytics Analyst II will partner with multiple customers across the Enterprise to provide more complex resolutions to analytics/data problems (i.e. descriptive statics, T testing, etc.) which require a study of situational factors, gathering information from several sources, and will provide reporting/analytic deliverables (i.e. tables, graphs, recommendations, etc.)

This position is responsible for performing RN duties for the Primary Nurse population using established guidelines to ensure appropriate level of care, as well as, planning for the transition to the continuum of care and developing a member centric plan of care. Primary Nurses will outreach to high risk members and will work to engage members in preventative care opportu

This is an Actuary position within the Risk Adjustment department. This position will require deep and significant analysis, and data mining, to ensure that accurate claims/encounter data. Develop mathematical modeling techniques and statistical concepts to determine probability and assess risks. This position will need to work closely with a multitude of departments, bei

The L&D Learning Consultant III is responsible for the development and delivery of curriculum with a focus on leadership. The L & D Learning consultant plays a crucial role in the design and the delivery of Horizon's Talent And Development Division's Leadership programming. Design, develop and deliver HR leadership programs to a variety of levels using multiple instructio

This position is responsible for performing RN 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. Serves as mentor/trainer to new RN's and other staff as needed. Subject matter expert for the various projects and com

The ASO Accountant I is responsible for the preparation, analysis, and completion of Minimum Premium and Self Insured invoices. This also includes compiling claims and traditional bills on a daily, weekly and monthly basis. The role is responsible for managing high dollar accounts and high priority Groups. Job Responsibilities Maintain accurate accounting sub ledgers for

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. Coordina

This field based position is responsible for performing assessments for PCA and MDC services using established guidelines and assessments to ensure appropriate level of care and services are authorized. Responsibilities Assesses patient's clinical need against established guidelines and/or standards to ensure that the services provided are medically appropriate to members

The Paralegal I provides legal support to the in house legal team at Horizon. The Paralegal I researches and analyzes law, investigates facts, conduct sand coordinates document collections, and prepares and maintains legal documents for review, approval, and use. The incumbent communicates with various internal and external contacts (including outside counsel), prepares b

he Director of Technology Strategy, Architecture & Governance at Horizon BCBS, will play a key role in shaping the technology direction of our organization. This is a strategic leadership position combines technical expertise and innovative problem solving skills and considered as a thought leader within the organization on Technology strategy & architecture. This positio