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Responsible for conducting audits and quality oversight activities for the MLTSS/DSNP Quality Assurance program. Collaborates with department to review outcomes, develop process improvement recommendations, and provide continuous education/training opportunities. Prepares reports, presents findings, and participates in program-wide improvement initiatives. Develops internal workflows and standardized guidelines for audits and processes.
The Financial/Accounting Analyst II will be responsible for financial planning and analysis, accounting activities, and reporting. They will work with various divisions and leadership teams to support budgeting, forecasting, and general ledger closing activities. Responsibilities also include handling special projects, conducting financial analysis, ensuring compliance, and preparing managerial reports.
Facilitate and lead negotiations with provider partners, collaborate with internal teams, prepare rate proposals, analyze contracts for cost savings, maintain contract language, adhere to standard payment methodologies, and contribute to network contracting strategy development.
The Risk Adjustment Data Analyst III is responsible for submission, monitoring, and validation of Risk Adjustment data. They collaborate with stakeholders, perform analysis, create technical documents, and contribute to program improvement. This role requires a minimum of five years of experience in programming or analytics, preferably in healthcare or insurance fields.
The Privacy Associate II is responsible for information governance and privacy compliance activities, risk assessments, and investigations to ensure compliance with laws and regulations. They also provide privacy regulation expertise, conduct data analysis, and deliver privacy compliance training.
Responsible for achieving strategic and financial goals for NovaWell through business development, sales strategy, relationship management, and customer success. Overseeing new business acquisition, account management, and marketing/communications functions. Building and maintaining relationships with senior-level decision-makers and ensuring customer satisfaction. Leading the sales strategy and contributing to revenue generation in alignment with corporate goals. Managing customer relationships and driving growth opportunities through strategic partnerships.
The Analytics Analyst II partners with multiple customers to provide complex resolutions to analytics problems, conducts quantitative analyses of healthcare data, prepares reports, and collaborates with cross-functional teams.
The ASO Accountant I is responsible for the preparation, analysis, and completion of Minimum Premium and Self Insured invoices. This also includes compiling claims and traditional bills on a daily, weekly, and monthly basis. The role involves managing high dollar accounts and high priority Groups.
Perform leadership, facilitation, analysis, and design tasks to develop enterprise solution architecture. Establish solution portfolios aligned with business objectives and guide project implementation. Ensure compliance with Enterprise Architecture.
The Financial Reporting Analyst III at Horizon BCBSNJ is responsible for financial, planning, and analysis tasks in the Corporate Finance department. They provide support to the finance team, conduct financial analysis, and prepare financial statements in compliance with accounting standards. The role involves complex analysis, reporting, and accounting activities, with a focus on accurate financial reporting and operational efficiency.
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