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 Township, NJ, 08618
Job Overview: The Physician Relations Representative is field based and is responsible for maintaining effective relationships with all facets of the provider community. The position is responsible for provider education, facilitation and resolution of complex, urgent problems. In addition, the Provider Relations Representative ensures compliance with Federal and State guidelines pertaining to ne...
Horizon Blue Cross Blue Shield of New Jersey - PROD Trenton, NJ, 08601
Job Overview: This position is accountable for supporting Pharmacy clinical management. The responsibilities include assisting in formulary management, medication therapy management, utilization management, research and collaboration with disease management and medical management. Major Responsibilities: Supports the pharmacy formulary management program, medication therapy management program, ...
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 Newark, NJ, 07101
Job Summary: This position is accountable for the review, interpretation and codification of Medical Policies and Legislative Mandates utilizing CPT-4, HCPC and ICD-9/ICD-10 coding parameters. Responsibilities: Reviews and interprets current Medical Policies for systematization. Translates written policy interpretation into CPT, HCPC, ICD-9/ICD-10 codes for input into systems. Translates Legi...
Horizon Blue Cross Blue Shield of New Jersey - PROD 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 Newark, NJ, 07105
The Security & Administration Divisional Manager will provide strategic and operational support in key areas of Security & Administration in the newly created Office of the Vice President, Administration and Chief Security Officer. Partner with divisional business teams regarding divisional, executive and board reporting Coordinate all compliance related matters of the business functions in the ...
Horizon Blue Cross Blue Shield of New Jersey - PROD Newark, NJ, 07101
Job Summary: This position is responsible for primarily managing the relationship between Horizon-BCBSNJ and the vendor for services as defined by contract. This includes conducting a review of vendor activities and providing direction to ensure performance service goal levels are met in the areas of customer satisfaction, billing, information systems requirements, performance guarantees, trainin...
Horizon Blue Cross Blue Shield of New Jersey 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 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 - 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 - PROD Ewing, NJ, 08560
Job Overview: This position is responsible for providing support to the Plan which includes interfacing with all Plan areas - loading, maintaining, and enhancing our various computerized files with the Provider Network; Provider Network analysis and reporting on information that is used to facilitate network recruitment activities. This position is also responsible for departmental training and u...
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 - PROD Newark, NJ, 07101
Job Summary: Under supervision of an Assistant General Counsel the Associate General Counsel is responsible for providing legal advice to management with regard to supporting Horizon Healthcare Management division of the company. The Associate General Counsel develops and maintains internal relationships and provides coordination with outside counsel when necessary. The Associate General Counsel ...
Horizon Blue Cross Blue Shield of New Jersey Newark, NJ, 07105
The Infrastructure Analyst V - Messaging is responsible for monitoring, supporting, and participating in the development/enhancements of distributive system management platforms. Resolve issues through level 3 in server, operating systems or other software under the control of the Distributed Systems management team Provide guidance to junior infrastructure analysts and follows guidance and dire...
Horizon Blue Cross Blue Shield of New Jersey - PROD 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 Mount Laurel, NJ, 08054
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 Newark, NJ, 07105
Job Summary: The Associate General Counsel - Litigation is responsible for the management of litigation and pre-litigation matters and providing legal advice to the Company with regard to various health insurance issues. This position must be a collaborative partner with the business to identify and respond to issues through proactive problem solving. Responsibilities: Provides advice to manage...
Horizon Blue Cross Blue Shield of New Jersey - PROD Newark, NJ, 07101
Job Overview: 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 pilot practices. The primary role of Partne...

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