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Clinical Analyst Analyst III-1
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 6 days ago
Medical Economics Consultant
Horizon Blue Cross Blue Shield of New Jersey
-
Newark, NJ
The Medical Economics Consultant provides support and consultation to the Medical Economics team through analyzing key business issues related to cost, utilization and revenue for all products at Horizon BCBS. This role will be responsible for the design and development of reports to monitor product performance and identify the root causes of medical cost trends. Responsi
Email Job
Posted 6 days ago
Clinical Care Associate
Horizon Blue Cross Blue Shield of New Jersey
-
Hopewell, NJ
Job Profile Summary This position is accountable for providing support to the field based Care Managers (RN II and Care Specialist III). In addition, Clinical Care Associates serve as the first point of contact for our members looking for service and/or provider information as well as members or providers requesting authorizations and denials of services. This position co
Email Job
Posted 6 days ago
Analytics Analyst III- SHBP Account Support
Horizon Blue Cross Blue Shield of New Jersey
-
Newark, NJ
The Analytics Analyst III will partner with multiple customers to provide more complex resolutions to analytics/data problems (i.e. linear models, pattern analysis, directional modeling, etc.) that require a more detailed and deeper study of situational factors, gathering information from several sources, and providing reporting analysis deliverables (i.e. tables, visual
Email Job
Posted 6 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 6 days 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 6 days 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 6 days 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 7 days 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 7 days ago
RN I-NICU-Medicaid-Care, Case and Disease Management
Horizon Blue Cross Blue Shield of New Jersey
-
Hopewell, 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. Responsibilities Assesses patient's clinical need against established guidelines and/or standards to ensure that the l
Email Job
Posted 8 days ago
Manager, Quality Audit & Coaching
Horizon Blue Cross Blue Shield of New Jersey
-
Newark, NJ
Responsible for the creation and execution of quality audit and coaching plans for new hires, existing employees, enterprise projects and service initiatives. Align resources to the business teams and vendor partners to support daily functions, nesting, and identification of trends, gap analysis and remediation. Monitor team performance against enterprise and divisional g
Email Job
Posted 9 days ago
Community Affairs Analyst
Horizon Blue Cross Blue Shield of New Jersey
-
Newark, NJ
This position is responsible for developing programs that enhance and support the Corporate Social Responsibility team's vision, strategic planning, financial management and funding operations that support the overall objectives of Horizon Blue Cross Blue Shield of New Jersey. This positon will oversee the Horizon Cares programs, Horizon's internal platform of benefits th
Email Job
Posted 10 days ago
Clinical Care Associate
Horizon Blue Cross Blue Shield of New Jersey
-
Hopewell, NJ
This position is accountable for assisting and extending support to the MLTSS RN/MLTSS Care Specialist working in the field. This position supports members based in the Community, Group Homes, Assisted Living and Long Term Care settings. This position also ensures facilitation of health care services within a member centric plan of care, under the direction and supervisio
Email Job
Posted 11 days ago
Medical Economics Analyst
Horizon Blue Cross Blue Shield of New Jersey
-
Newark, NJ
The position is primarily responsible for driving and producing various financial reporting and analytical activities that support Healthcare Management's P&L evaluation on routine basis that lead to key medical cost savings action plans. Key focus areas include developing a detailed understanding of the composition of monthly and year to date revenue and medical cost, in
Email Job
Posted 11 days ago
Analytics Analyst III/ANA15-1
Horizon Blue Cross Blue Shield of New Jersey
-
Newark, NJ
The Analytics Analyst III will partner with multiple customers to provide more complex resolutions to analytics/data problems (i.e. linear models, pattern analysis, directional modeling, etc.) that require a more detailed and deeper study of situational factors, gathering information from several sources, and providing reporting analysis deliverables (i.e. tables, visual
Email Job
Posted 11 days ago
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