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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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>Participates in the Pharmacy Case Management Program.Supports the pharmacy lock ... accountable for supporting Pharmacy clinical management. The responsibilities include assisting in formulary
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
...
, Pennsylvania, Connecticut or DelawareJob Summary:The Assistant General ... by management.Healthcare:Monitors changes in the legal
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
...
is accountable for the assessment and case management of members to ensure facilitation of health ... >Encourages member participation and compliance in the case management program efforts.</p
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
...
is accountable for the assessment and case management of Dual Special Needs members using established ... /or telephonic case management activities specific to the Dual Special Needs program.</p
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
...
prepare reports for senior management and the Board of Directors.Interact with OCR or other ... -hoc tasks from management.Addendum: May assist in
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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>Participates in the Pharmacy Case Management Program.Supports the pharmacy lock ... accountable for supporting Pharmacy clinical management. The responsibilities include assisting in formulary
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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participation and compliance in the case/disease management program efforts.Documents accurately and ... knowledge of case/care management principles.Prefers working knowledge of principles of utilization
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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transactions.Responsibilities:Analyzes existing HR data management ... Capital Management, and Benefits.Manages and/or participates in the implementation and
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
...
reports of delegates and communicates audit findings, recommendations, and trends to senior management via ... .Requires excellent presentation skills.Requires management skills.</p
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
...
the requirements of the BCBSA Directors office as well as the Federal Office of Personnel Management ... of each case. Horizon also provides a comprehensive compensation and benefits package which includes
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
...
of each case. Horizon also provides a comprehensive compensation and benefits package which includes
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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communicating case management services interaction with stop loss management.Performs other duties as ... certification in case management or other applicable clinical specialties.Knowledge:</p
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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responsible for the build and execution of recurring management processes for Actuarial Services. The Manager ... Segment Management Process and partner with leaders across Actuarial, Marketing, Sales, Underwriting, and
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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management disciplines- Develop road maps describing the evolution of all enterprise solution portfolios from current state to future state- Work closely with the enterprise program management office
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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a strategic approach to BH
management at the market and account level by establishing relationships ... with development of strategic approach to
management of national/corporate accounts.<p
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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applications.Requires working knowledge of case/care/disease management principles.Requires working knowledge of operations of utilization, case and/or disease management processes
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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tasks as assigned by management.ADDENDUM FOR QUALITY AUDIT MEASUREMENT TEAM ANALYSTS ... other insurance rating systems requiredKnowledge of Project Management methodologies<li
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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use of intranet and internet applications.Working knowledge of case/care management ... Assessments for new referrals to MLTSS.Assists with MLTSS Case Management when necessary, to cover
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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case/care management principles.Working knowledge of principles of utilization management.</li ... to enhance member outcomes.Completes other assigned functions as requested by management
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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enterprise-wide information government and data privacy programs and will participate in the management and ... security standards, guidelines and best practices.Advises business teams and management of
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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responsible for supporting the Quality Management department with improvements through project planning ... >Develop project initiatives, process and performance measures for Quality Management and deliverables to
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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Management and all departments utilizing provider date including the screening of provider loading, as well ... of attention and performing other duties as assigned by management.<font class="bold
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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accountable for providing support to Network Data Management and all departments utilizing provider date ... management.Responsibilities:Assists with the direction and supervision
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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applications.Working knowledge of case/care management principles.Working knowledge of ... Assessments for new referrals to MLTSS.Assists with MLTSS Case Management when necessary, to cover
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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efforts to develop and maintain information governance frameworks and standards, including management of ... Abilities:Organization and management of multiple priorities.Proficient in
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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a strategic approach to BH management at the market and account level by establishing relationships ... ">Responsibilities:Leads Client Liaison team through the management, development and training of
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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and delinquent payments to management timely to ensure payments are made promptly or so that a ... experience in lieu of degree.Requires a minimum of 1-2 years of billing and client management
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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>Perform other relevant tasks as assigned by management.ADDENDUM FOR ... required.Knowledge of Project Management methodologies.May require
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Horizon Blue Cross Blue Shield of New Jersey
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Newark, New Jersey
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">Knowledge:Project management skills.Expert PowerPoint skills.</p ... each case. Horizon also provides a comprehensive compensation and benefits package which includes:</p
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