Jobs at Horizon Blue Cross Blue Shield of New Jersey

The Data Financial Reporting Analyst manages data supporting revenue and accounts receivable, performs complex financial analysis, and prepares reports for management. They lead junior analysts, ensure accurate month-end activities, support Medicaid revenue reporting, and engage in special projects while maintaining relationships with internal stakeholders.

The Pharmacy Specialist I is responsible for processing prior authorization requests, engaging with healthcare professionals, and maintaining compliance with regulations, while ensuring quality service metrics are met.

The Quality Management Specialist supports project planning and implementation, analyzes data for quality improvements, manages budgets, and enhances healthcare services through collaboration and performance measurement.

Lead the managed long term support services program clinical care team, ensuring compliance and quality service delivery while managing operations and staff performance.

The Digital Products Reporting Manager will lead and develop reporting and analytics strategies for digital products, present insights to stakeholders, and analyze performance and trends to enhance user experiences and project outcomes.

The Account Manager I is responsible for managing contract renewals, selling additional products, ensuring account retention, and conducting client workshops.

The RN I position involves assessing patient care needs, coordinating care services, monitoring quality, advocating for members, and documenting healthcare activities. Requires interaction with multidisciplinary teams and understanding of utilization management.

The role involves conducting data analysis for process improvement, leading initiatives, mentoring staff, and developing business cases using ROI models to enhance efficiency and reduce costs.

The Senior HR Business Partner serves as a strategic advisor to executives, shaping people strategies to enhance organizational effectiveness, culture, and employee experience while managing complex HR functions.

The role involves creating technology strategies for applications, managing a large tech team, overseeing project lifecycles, vendor relationships, and budget management to ensure quality and service levels in IT deliveries.

Oversee the Information Security Risk program, manage relationships across governance bodies, and lead a team to mitigate security risks.

The Account Manager IV is responsible for retaining client accounts and selling additional services within the Labor market. This role includes managing renewals, maintaining relationships with stakeholders, resolving issues, and providing strategic support across labor groups.

Responsible for managing clinical pharmacy programs, formulary management, medication therapy management, and assisting medical teams with drug information services and prior authorizations.

The Strategic Initiatives Analyst supports enterprise initiatives through research, data collection, analysis, and effective presentations. The role requires both independent and collaborative work and the ability to synthesize complex information into actionable recommendations.

The Regulatory Compliance Associate ensures compliance with health regulations by analyzing legislative changes, guiding operational compliance, gathering data for reporting, and collaborating with internal divisions.

The Senior Manager leads Desktop Engineering and Messaging teams, ensuring secure and efficient end-user experiences, driving operational excellence and modernization while aligning with business objectives.

The role involves strategic management of sales teams, driving new business, enhancing client relationships, budget management, and ensuring service delivery excellence.

The Director of the AI Center of Excellence will lead AI initiative execution, drive innovation, influence strategy, and ensure compliance within healthcare regulations while managing resources and promoting ethical AI practices.

The OON Mandate Arbitration Analyst researches and analyzes complaints and inquiries related to the No Surprises Act, prepares documentation, and assists legal teams with data and case reviews.

The Sales Executive IV drives new account sales across various markets, focusing on meeting sales targets and building relationships with clients and brokers.