HorizonBlue Cross Blue Shield New Jersey Jobs & Careers

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19 HorizonBlue Cross Blue Shield New Jersey jobs found on Monster.

Jobs 1 to 19 of 19
Horizon Blue Cross Blue Shield of New Jersey - PROD Ewing Twp, NJ, 08618
Job Summary: This position is responsible for negotiating, implementing and maintaining contracts between HNJH and assigned Managed Long Term Services and Supports (MLTSS) providers which may include but not be limited to, Personal Care Agencies, Medical Day Centers, Nursing Facilities, Community Alternative Residential Settings and Non-Traditional providers ensuring that the contractual arrangem...
Horizon Blue Cross Blue Shield of New Jersey Ewing, NJ, 08628
The Divisional Information Leader III identifies changes and trends in computer and systems technology and interprets their meaning to senior management. The candidate participates in overall business planning; bringing a current knowledge and future vision of technology and systems as related to the organization’s competitive position. Additionally, the role determines long term organization wide...
Horizon Blue Cross Blue Shield of New Jersey - PROD Newark, NJ, 07101
Job Overview: This position is responsible for individual account sales, through development of new prospects and establishing relationships with existing customers to produce new sales. Major Responsibilities: Develops contacts to produce Sales. Informs and educates clients on HZN products and services. Ensures clients are informed of relevant legislative and regulatory issues and their asso...
Horizon Blue Cross Blue Shield of New Jersey Newark, NJ, 07105
The Business Process Improvement Implementation Manager II reports to the Manager of Enterprise Business Process Improvement and is responsible for conducting data collection and analysis to support process improvement projects to reduce cost and complexity across the enterprise. As a Business Process Improvement Manager, the incumbent will draft and review project deliverables and analysis such a...
Horizon Blue Cross Blue Shield of New Jersey Newark, NJ, 07101
Job Summary: This position is the Senior Investigator within the Special Investigations Unit investigative activities (external and internal) related to claims, enrollment, accounting and other operations to detect, receive and review suspected fraud and to complete cases with all information and analysis for resolution as the manager and prior approved guidelines may direct. Responsibilities: ...
Horizon Blue Cross Blue Shield of New Jersey Newark, NJ, 07105
Job Summary: Perform analytical studies related to Risk Adjustment. Assist in implementing the RA under ACA. Coordinate with Medicare and Medicaid risk adjustment programs. Responsibilities: The primary responsibility is to perform risk adjustment analytical studies that involve manipulations of large amounts of data; apply advanced programming techniques to streamline the analysis. Conduct gap...
Horizon Blue Cross Blue Shield of NJ Newark, NJ, 07101
Job Summary: This position will be part of an innovative program changing the model for health care delivery. The Partner Outcomes and Relationships Specialist is a member of Horizon Healthcare Innovations (HHI) Clinical Innovation team, and supports the Manager, Partner Contracting, Outcomes and Relationships for the on-going assessment and support of practices participating in the programs. The...
Horizon Blue Cross Blue Shield of New Jersey - PROD Newark, NJ, 07101
Job Summary: This position is responsible the daily support and administration of the reimbursement system(s) for participating acute care physicians, hospitals and ancillary institutional providers. Additional duties include analysis, problem solving, handling of system specifications and acting as a liaison to other divisions and external customers. Responsibilities: Perform and assist with q...
Horizon Blue Cross Blue Shield of New Jersey Trenton, NJ, 08601
Job Summary: 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. Responsibilities: Performs duties and types of care management as assigned by management. Serves as mentor/trainer to new RN's and other staff as needed. Assesses patient's clinical need against est...
Horizon Blue Cross Blue Shield of New Jersey - PROD Newark, NJ, 07105
The Director, Security Operations is responsible for the development of short and long term strategies for Horizon’s Security Operations group, as well as to align with Horizon's enterprise strategy and to ensure optimization of Horizon’s infrastructure, resources and capabilities. This role translates strategies into tactical functions and develops Security system architecture to ensure they can ...
Horizon Blue Cross Blue Shield of New Jersey Newark, NJ, 07105
The Enterprise Information Security Architect will apply a combination of business process analysis and technical knowledge to develop enterprise security architectural deliverables that identify and describe the relationships among functions, data, applications and technology at various levels at Horizon-BCBSNJ. The person will perform individual assignments and lead project teams composed of Bus...
Horizon Blue Cross Blue Shield of New Jersey Newark, NJ, 07105
This leadership role is responsible for managing payroll operations for Horizon, proactively engaging and advising senior leadership, overseeing payroll accounting and ensuring payroll taxes, garnishments and 401(k) reconciliations are handled properly. This role partners with and supports internal users and management with issue resolution, new process development, and manages outsource service p...
Horizon Blue Cross Blue Shield of New Jersey Newark, NJ, 07105
Job Summary: This position manages complex, strategic projects that span organizational boundaries that involve external vendors and multiple divisions or business areas. This position will have dotted-line reporting relationships and must be able to negotiate with others to meet program/portfolio objectives. Accountable for day-to-day management of a BlueList program or portfolio encompassing m...
Horizon Blue Cross Blue Shield of New Jersey - PROD Newark, NJ, 07101
Job Summary: The Paralegal provides transactional support, researches and analyzes law, investigates facts, conducts and coordinates document collections, and prepares and maintains legal documents for review, approval, and use. In carrying out these job duties, the Paralegal will communicate with various intra-company departments and external contacts (including attorneys), prepare business corr...
Horizon Blue Cross Blue Shield of New Jersey Newark, NJ, 07105
The Divisional Manager will provide strategic, financial and operational support in key areas to the newly created Office of the Vice President, Administration and Chief Security Officer. Responsibilities will include: Partner with divisional business teams regarding divisional, executive and board reporting Coordinate all compliance related matters of the business functions in the division Pri...
Horizon Blue Cross Blue Shield of New Jersey Newark, NJ, 07105
Job Summary: This position has technical and management responsibilities of an IT functional area. The individual assigns work, develops and maintains project plan, performs resource management, develops time and cost estimates, monitors budget for area of responsibility and performs HR activities for team members. The individual directs team by setting priorities, coordinating, and reporting gro...
Horizon Blue Cross Blue Shield of New Jersey Trenton, NJ, 08601
Job Summary: This position is accountable for physician outreach, relationship management, issue identification and resolution, and problem avoidance. This is achieved by serving as the primary member of a team made up of people from various functional areas in the end-to-end provider experience process and is responsible to support the team for the benefit of the providers assigned to the pod/te...
Horizon Blue Cross Blue Shield of New Jersey Newark, NJ, 07105
The HR Generalist II provides direction, expertise and operational support to designated division(s) on the employee and labor relations function. The candidate will ensure that Human Resources initiatives and services are provided to division(s) in support of divisional objectives and goals. The position will also: Assist with the implementation of HR programs within division(s) to assure their ...
Horizon Blue Cross Blue Shield of New Jersey - PROD Newark, NJ, 07101
Job Overview: Responsible for the development, issuance, maintenance, revision, review and interpretation of group and non-group specific contracts, booklets and related materials. Acts as an information resource and provides technical training for new and existing staff, ensuring that unit's work flow runs smoothly and that standards are met. Major Responsibilities: Develops, reviews, updates ...

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