-
Business Analyst III
Found in: Lensa US P 2 C2 - 13 hours ago
Horizon Blue Cross Blue Shield of New Jersey Newark, United StatesHorizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware · Job Summary: · Responsible for conducting research and root cause analysis for customers with the goal of recommending and implementing new processes and solutions to operational d ...
-
Ancillary Contracting Specialist I
Found in: Lensa US 4 C2 - 2 days ago
Horizon Blue Newark, United StatesAncillary Contracting Specialist I page is loaded · Ancillary Contracting Specialist I · Apply · locations · Newark, NJ - Remote · time type · Full time · posted on · Posted Yesterday · job requisition id · Job Summary: · This position is responsible for overseeing cont ...
-
clinical risk adjustment management rn
Found in: Careerbuilder One Red US C2 - 5 days ago
Blue Cross and Blue Shield Association Newark, NJ , USA, United StatesHorizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware · Job Summary: · This position will perform care management duties specifically targeting high-risk members within Medicare Advantage/Commercial risk adjusted populations to enhance ...
-
clinical risk adjustment management rn
Found in: Careerbuilder One Red US C2 - 5 days ago
Blue Cross and Blue Shield Association Newark, NJ , USA, United StatesHorizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware · Job Summary: · This position will perform care management duties specifically targeting high-risk members within Medicare Advantage/Commercial risk adjusted populations to enhance ...
-
Program Manager, GreenLight Greater Newark
Found in: Lensa US 4 C2 - 1 day ago
GreenLight Fund Newark, United StatesProgram Manager, GreenLight Fund Greater Newark · Organization Overview · GreenLight Fund is a national nonprofit with a local focus that partners with communities to create opportunities for inclusive prosperity. · Each year we facilitate a community-driven process that match ...
-
Program Manager, GreenLight Greater Newark
Found in: Lensa US 4 C2 - 23 hours ago
GreenLight Fund Newark, United StatesProgram Manager, GreenLight Fund Greater Newark · Organization Overview · GreenLight Fund is a national nonprofit with a local focus that partners with communities to create opportunities for inclusive prosperity. · Each year we facilitate a community-driven process that match ...
-
exercise specialist
Found in: Careerbuilder One Red US C2 - 5 days ago
RWJBarnabas Health Newark, NJ , USA, United StatesExercise SpecialistReq #: · Category:Occupational Therapy · Status:Full-Time · Shift:Day · Facility:Newark Beth Israel Medical Center · Department:Cardiac Rehabilitation · Location: · Newark Beth Israel Medical Ctr, 201 LYONS AVENUE, NEWARK, NJ · Job Overview · Plan and impleme ...
-
Business Systems Analyst III
Found in: Lensa US P 2 C2 - 13 hours ago
Horizon Blue Cross Blue Shield of New Jersey Newark, United StatesHorizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware · Job Summary: · This position is responsible for analyzing, understanding and translating business needs into business/technical requirements with minimal supervision. Conduct unsup ...
-
clinical analyst analyst iii
Found in: MyJobHelper US C2 - 4 days ago
Blue Cross and Blue Shield Association Newark, NJ , USA, United StatesHorizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware · Job Summary: · The role is a technical lead that requires deep knowledge, skills, and experience in designing and carrying out clinical analytics. The position is a key team member ...
-
Supervisor
Found in: Lensa US 4 C2 - 1 day ago
RWJBarnabas Health Newark, United StatesSupervisor · Req #: · Category: · Behavioral and Mental Health · Status: · Part-Time · Shift: · Day · Facility: · Newark Beth Israel Medical Center · Department: · GR-Regional Diagnostic Treatme · Location: · Newark Beth Israel Medical Ctr, · 201 LYONS AVENUE, NEWARK, ...
-
professional resident-2
Found in: Careerbuilder One Red US C2 - 4 days ago
Blue Cross and Blue Shield Association Newark, NJ , USA, United StatesHorizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware · Job Summary: · This is a one-year, structured post-graduate education and training program in a Medicaid managed care HMO. The goal of the position is to provide advanced knowledge ...
-
HEDIS Quality Auditor II RN/SW
Found in: Lensa US P 2 C2 - 13 hours ago
Horizon Blue Cross Blue Shield of New Jersey Newark, United StatesHorizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware · Job Summary: · Responsible for conducting file audits for all areas of clinical operations. These audits review daily business practice compliance to regulatory compliance relati ...
-
Sales Exec I
Found in: Lensa US 4 C2 - 6 days ago
Blue Cross Blue Shield companies Newark, United StatesHorizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware · Job Summary: · This position is responsible for individual account sales, received from clients responding to promotional materials and phone inquiries. · * Informs and educates cl ...
-
Risk Adjustment Analyst
Found in: Lensa US 4 C2 - 6 days ago
Horizon Blue Cross Blue Shield Newark, United StatesRisk Adjustment Analyst page is loaded **Risk Adjustment Analyst** · **Risk Adjustment Analyst** · locationsNewark, NJ - Hybrid time typeFull time posted onPosted 8 Days Ago job requisition id **Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connectic ...
-
Dir, Account Services SHBP
Found in: Lensa US 4 C2 - 6 days ago
Horizon Blue Cross Blue Shield of New Jersey Newark, United StatesHorizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware · Job Summary: · The role will help to ensure Horizon BCBSNJ's ability to strengthen and maintain strong relationships with the leadership of New Jersey State Health Benefits progra ...
-
dsnp field rn i-passaic county, nj- $5k new hire sign on
Found in: Careerbuilder One Red US C2 - 5 days ago
Blue Cross and Blue Shield Association Newark, NJ , USA, United StatesHorizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware · Job Summary: · This field based position is responsible for performing assessments for PCA and MDC services using established guidelines and assessments to ensure appropriate level ...
-
Integration Lead
Found in: Lensa US P 2 C2 - 13 hours ago
Horizon Blue Cross Blue Shield of New Jersey Newark, United StatesJob Summary: · The Integration Lead is responsible for leading implementations and enterprise-wide projects, analysis, and/or initiatives for NovaWell. This position drives key business outcomes for NovaWell BH through a blend of project management, enterprise analysis, with staf ...
-
field rn ii-medicaid-care, case and disease management- essex/hudson nj counties
Found in: Careerbuilder One Red US C2 - 5 days ago
Blue Cross and Blue Shield Association Newark, NJ , USA, United States Full timeHorizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware · Job Summary: · This position is responsible for performing RN duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the ...
-
IT Data Analyst III
Found in: Lensa US P 2 C2 - 13 hours ago
Horizon Blue Cross Blue Shield of New Jersey Newark, United StatesJob Summary: · Data analysts are experts with strong understanding of data structures and analysis. They are responsible for ensuring requirements around the accuracy, quality, completeness, and timeliness of data are captured and understood. They work hand in hand with Data Mode ...
-
ASO Accountant I
Found in: Lensa US 4 C2 - 2 hours ago
Horizon Blue Cross Blue Shield of New Jersey Newark, United StatesHorizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware · Job Summary: · The ASO Accountant I is responsible for the preparation, analysis, and completion of Minimum Premium and Self Insured invoices. This also includes compiling claims ...
Group Underwriter Horizon Blue Cross of NJ - Newark, United States - ShiftCode Analytics
Description
This is Hybrid Role.
candidates have to have at least a few years of Health Insurance Underwriting experience.
Job Summary for Group Underwriter III position:
This position is accountable for the underwriting analysis and interpretation of specific large group experience and writing and retaining profitable business.
Also responsible for developing benefit change proposals and participating in special projects.Develops and issues proposal rates for group size 51+ and experience rated proposals. Participates in completion of bid responses for Requests for Proposals (RFPs) and renewals providing rating and financial support.
Develops and issues experience rated renewals for group size 51+.
Develops annual renewal presentation by evaluating group specific experience, employing underwriting judgment and suggesting financial alternatives.
Approves Group Enrollment Information (GEI) and Benefit Information Forms (BIFs) where applicable.
Researches rate and benefit inconsistencies and issues corrections and/or recommendations.
Assembles data and produces ERISA 5500 reports and settlements and issues to Sales, where applicable.
Makes decisions to offer special financial arrangements to groups and monitors outcomes as required.
Attends meetings with groups and brokers to discuss renewals and proposals and makes recommendations.
Maintains and updates monthly financial reports necessary for Enterprise Operations.
Participates and leads departmental projects which may include testing programs for accuracy and use, as needed.
Covers for manager and trains junior staff as assigned by management
Performs other duties as assigned by management.
Core Competencies
Personal and professional attributes that are critical to successful performance for Individual Contributors:
Customer Focus
Accountable
Learn
Communicate
Education/Experience
Bachelors degree in Math, Finance, Statistics, Economics, or Accounting preferred or relevant work experience in lieu of degree.
Requires minimum five (5) years rating and underwriting group health insurance.
Additional licensing, certifications, registrations
Requires knowledge of underwriting principles, new business rating methodology, benefit offerings, and financial mechanisms.
Prefer knowledge of Client products.
Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes; Should be knowledgeable in the use of intranet and internet applications.
Requires strong proficiency in Microsoft Excel.Skills and Abilities
Requires excellent Math abilities to be determined via interview and/or testing.
Analytical & Problem Solving Skills
Decision Making
Negotiation
Attention to Detail
Customer Focus
Self-Motivated
Presentation
Leadership
Travel (If Applicable)
Salary Range:
$83,000 - $113,295
This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity.
This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case.Horizon also provides a comprehensive compensation and benefits package which includes:
Comprehensive health benefits (Medical/Dental/Vision)
Retirement Plans
Generous PTO
Incentive Plans
Wellness Programs
Paid Volunteer Time Off
Tuition Reimbursement