Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health.  For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience.  Our members are our neighbors, our friends, and our families.  It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. 

About the Role

Accountable for providing subject matter support to the account management teams that manage SHBP, with a focus on key strategic relationships within the market. This position will focus on building and maintaining strategic relationships with the various SHBP stakeholders, as well as supporting others within the team to do so. This position is indirectly responsible for increasing the profitability of the book of business and expanding membership and revenue.

What You'll Do

• Provides subject matter support to the account management teams in areas related to underwriting, ancillary products, benefit design, and market-specific dynamics.

• Serve as the subject matter expert for billing operations, ensuring accurate billing administration and timely resolution of billing inquiries and discrepancies.

• Maintain accurate and updated billing master roster.

• Develop and maintain monthly, quarterly, and annual forecasts, identifying trends, variances, risks, and opportunities impacting financial performance.

• Support of plan design implementations, ensuring accurate translation of State legislation into business requirements.

• Act as the business lead for vendor integrations serving State members.

• Serves as a liaison for account management team and other support areas within the organization that impact client management.

• Manage database of individual stakeholders within the market and their connections.

• Provides assistance in developing strategic business plan to retain and grow within the SHBP Plan.

• Train newly hired staff on the unique SHBP Market.

What You Bring

Education/Experience:

• Prefers Bachelors degree from an accredited college or university.

• Requires a minimum of 10 years of experience in group health.

• Experience managing in a fast paced, performance driven environment necessary.

• Knowledge of complex billing operations preferred

Knowledge:

• Must be proficient in the use of personal computers and supporting software in a Windows based environment.

• Knowledge of health insurance plans, health care delivery systems, and claim operations.

• Knowledge and understanding of pricing and underwriting principals.

 

Why Horizon?

At Horizon, you’ll do meaningful work that directly improves lives—while being supported by a mission‑driven organization that values expertise, collaboration, and growth.  We believe that when our people thrive, our communities do too.  If you are passionate about making an impact, we’d love to hear from you!

Salary Range:

$97,800 - $133,455

​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:

• Comprehensive health benefits (Medical/Dental/Vision)

• Retirement Plans

• Generous PTO

• Incentive Plans

• Wellness Programs

• Paid Volunteer Time Off

• Tuition Reimbursement

Disclaimer:

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

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.