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Medical Director
Horizon Blue Cross Blue Shield of New Jersey
-
Hopewell, NJ
The Medical Director is a medical spokesperson for Horizon Blue Cross Blue Shield with the provider network across NJ. The Medical Director will be accountable for providing leadership, direction and daily support for their assigned region of NJ and assigned providers; the scope of activities include, but are not limited to, utilization management, care management, diseas
Email Job
Posted 26 days ago
Ancillary Contracting Specialist I
Horizon Blue Cross Blue Shield of New Jersey
-
Newark, NJ
This position is responsible for overseeing contracts between hospitals in the Select Hospital Network or ancillary contracts (i.e. SNF's Sub acute, Home IV, etc.) and Horizon Blue Cross Blue Shield, and for ensuring that the contractual arrangement is fulfilled. Accountability's may include developing, negotiating and managing the ancillary contracting arrangements. In a
Email Job
Posted 26 days ago
Risk Adjustment Data Analyst IV
Horizon Blue Cross Blue Shield of New Jersey
-
Newark, NJ
The Data Analyst leads the technology process for the end to end Risk Adjustment Processing System (RAPS) and Encounter Data Processing System (EDPS) data flow and works within key regulator guidelines for acceptable data submission. Using SQL and SAS programs lead the gathering of data for submissions Risk Adjustment. As the senior analyst of data, will be responsible fo
Email Job
Posted 27 days ago
Identity & Access Management Engineer-2
Horizon Blue Cross Blue Shield of New Jersey
-
Newark, NJ
The Identity and Access Management (IAM) Engineer will collaborate cross functionally with Security Architects, Senior Infrastructure Analysts, and Senior Application Developers to provide a stable WAM environment by applying new and best practices in Identity and Access Management and Customer IAM technologies to support business applications. This position will be respo
Email Job
Posted 27 days ago
Quality Improvement Data Analyst
Horizon Blue Cross Blue Shield of New Jersey
-
Hopewell, NJ / Wall, NJ / Newark, NJ
This position contributes to Quality Improvement efforts through the research, analysis, design, programming, implementation and coordination of accurate and timely reporting. The incumbent will partner with multiple customers across the Enterprise to provide complex resolutions to analytics/data problems and will provide reporting/analytic deliverables (i.e. tables, grap
Email Job
Posted 27 days ago
Clinical Analyst Analyst III
Horizon Blue Cross Blue Shield of New Jersey
-
Newark, NJ
The role is a technical lead that requires deep knowledge, skills, and experience in designing and carrying out clinical analytics. The position is a key team member collaborating in a multi disciplinary business environment with colleagues across the enterprise to lead clinical performance analytics, development, and reporting that deliver actionable clinical insights to
Email Job
Posted 1 month ago
Auditor II
Horizon Blue Cross Blue Shield of New Jersey
-
Newark, NJ
Reporting directly to an Audit Manager, responsibilities include developing the scope of audits, programs or initiatives, executing testing and reporting in a quality manner, and the identification as well as tracking of issues to closure. Responsibilities Executes assigned planning, data gathering, analysis and testing tasks independently and in the timeframe established
Email Job
Posted 1 month ago
IT Data Analyst III
Horizon Blue Cross Blue Shield of New Jersey
-
Newark, NJ
Job Summary Data analysts are experts with strong understanding of data structures and analysis. They are responsible for ensuring requirements around the accuracy, quality, completeness, and timeliness of data are captured and understood. They work hand in hand with Data Modelers, Data Developers, Data Stewards and Business SMEs to ensure the customers data needs are acc
Email Job
Posted 1 month ago
Sales Exec I - Telephone Sales
Horizon Blue Cross Blue Shield of New Jersey
-
Newark, NJ
This position is responsible for individual account sales, received from clients responding to promotional materials and phone inquiries. Informs and educates clients on select HZN products and services Ensures clients are informed of relevant legislative and regulatory issues and their associated impact Facilitates the enrollment process for new individual sales. Ensures
Email Job
Posted 1 month ago
Field RN II-Medicaid-Care, Case and Disease Management- Essex/Hudson NJ Counties
Horizon Blue Cross Blue Shield of New Jersey
-
Newark, NJ
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
Email Job
Posted 1 month ago
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