Teams at Horizon Blue Cross Blue Shield of New Jersey

Lead and execute provider network contracting and negotiations across Commercial, Medicare, Medicaid, DSNP, MLTSS and casualty lines. Prepare rate proposals with Medical Economics and Actuary, ensure accurate contract implementation and system configuration, analyze contracts for cost savings, maintain contract language and templates, collaborate with Legal/Compliance and internal partners, and support value-based payment initiatives and network strategy.

Analyzes business needs, gathers requirements, researches solutions, creates technical documentation and timelines, and participates in the software development lifecycle. The role stress-tests solutions, supports UAT, maps and maintains financial data tables, and collaborates with IT and Analytics on data issues. It requires experience with Snowflake, SQL, Power BI, or Python, plus knowledge of health insurance data domains, system development methodologies, and process analysis.

Manages complex national large-group health insurance accounts, focusing on retention, renewals, contract negotiations, product expansion, client relationships, service performance, and issue resolution. Advises clients, brokers, trustees, and consultants; coordinates with internal teams and vendors; delivers reporting, workshops, and regulatory updates; and makes financial, operational, and service-related decisions. The role requires national travel, strong negotiation and presentation skills, health insurance knowledge, and a New Jersey Health/Life license.