Job description
Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware
Job Summary:
This position is accountable for the daily management, training and development of staff, overseeing department work assignments, activities and special projects, and providing area oversight in ensuring progress towards achievement of objectives/goals and the delivery of exceptional customer service. The position will interact with various internal and external stakeholders as well as cross-divisional partnerships.
Responsibilities:
- Responsible for ensuring staff meets all regulatory requirements and comprehends and complies with best practices, professional standards, internal policies, and procedures.
- Manages and directs staff to provide the appropriate level of service and to ensure overall customer satisfaction is delivered. Directs staff in the development, analysis, and preparation of reports.
- Conducts monitoring activities as required for area of oversight to include accuracy and compliance with internal/external policies, applicable workflows and business rules.
- Oversees and coordinates department activities and special projects to ensure achievement of productivity, quality and established timetables.
- Coordinates and communicates outcomes to internal and external stakeholders which may include presentations and business case preparation.
- Acts as subject matter expert in resolving complex issues. Participates on committees and/or leads departmental and interdepartmental workgroups. Performs other duties as assigned by management.
- Develops key performance indicators to evaluate level of service for internal and external customers. Performs other duties as assigned by management.
- Creates and champions an atmosphere within the team, which fosters open communication, teamwork, ownership, and a collaborative cross-departmental environment to implement, optimize and share continuous improvement processes.
- Manages, directs, and develops staff by providing feedback and coaching. Administers performance and salary reviews for staff. Assists in preparing and monitoring the budget to ensure administrative cost objectives are met. Provides new employee onboarding, trains, develops and mentors direct staff. Manages and coordinates staff assignments to include: rotations, employee training, vacations, break times and overtime assignments.
Education/Experience:
- Prefers Bachelor's degree required from an accredited college or university in business administration or related field. In lieu of degree an additional 4 years' work related experience in the healthcare industry required.
- Require minimum of two year's healthcare industry or operations experience.
- Prefer minimum of one year direct supervisory experience or demonstrated experience leading teams in a matrix management environment.
- Prefer a minimum of eighteen months experience in the health insurance industry.
Knowledge:
- Requires knowledge of the healthcare industry.
- Prefers knowledge of health care systems and medical documentation.
- Prefers knowledge in a medical utilization management platform
Skills and Abilities:
- Requires the ability to express thoughts clearly and concisely both orally and written.
- Requires the ability to obtain the skills possessed by the team members and system technical competence.
- Requires the ability to effectively lead team members in diversified tasks.
- Requires excellent organizational skills.
- Requires excellent presentation skills.
- Requires the ability to think analytically and to report findings in an accurate manner.
- Requires proficiency in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Outlook. Should be knowledgeable in the use of intranet and internet applications.
Travel % (If Applicable):
- Travel required to other Horizon offices, provider locations and/or for oversight of remotely located workforce members in accordance with Company needs
Salary Range:
$75,300 - $100,800
This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:
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Comprehensive health benefits (Medical/Dental/Vision)
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Retirement Plans
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Generous PTO
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Incentive Plans
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Wellness Programs
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Paid Volunteer Time Off
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Tuition Reimbursement
Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.
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