Teams at Horizon Blue Cross Blue Shield of New Jersey

Performs utilization and care management duties for members, assessing clinical needs, coordinating care across providers, monitoring outcomes, documenting per policy, mentoring staff, participating in quality improvement, and serving as subject-matter expert on projects and user-acceptance testing. Advocates for members and supports Clinical Advocate outreach and benefits education.

Lead job architecture initiatives and compensation strategies, provide market pricing oversight, mentor junior staff, and support compensation projects across divisions.

Responsible for assessing patients' clinical needs, coordinating care, and ensuring appropriate services while advocating for members in the healthcare continuum.