Offer summary

Qualifications:

High School Diploma/GED required., Minimum of four years' experience in an operational or analytical role., Strong computer skills in Microsoft Office products, including Access and Excel., Knowledge of the healthcare industry is preferred..

Key responsabilities:

Investigate service-related issues to identify root causes and communicate business needs.

Create forecasting tools and assist IT with technical specifications based on business requirements.

Recommend solutions to improve business efficiency and participate in project workgroups.

Conduct User Acceptance Testing (UAT) and prepare materials for audit activities.

Job description

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.

Under general supervision conducts research and root cause analysis for customers with the goal of recommending and implementing new processes and solutions. Resolves issues and improves operational performance on a cross-functional/departmental basis. This is an intermediate level position and may require guidance.

Responsibilities:

Investigate service related issues to identify root cause of issues; identify and communicate business needs assessments as necessary.
May create forecasting tools using current technology/systems (Access, Excel, Monarch, etc.)
May translate business requirements and assist IT with the development of technical specifications.
Recommend solutions based on data analysis to increase business efficiency and/or improve existing processes.
Participate in internal and external project workgroup(s) and presentations.
Conduct User Acceptance Testing (UAT) for projects, implementations, system fixes and enhancements, etc.
Prepare materials for internal and external audit activities; may review audit findings/reports for accuracy and completeness.
Perform other relevant tasks as assigned by management.

QUALITY AUDIT MEASUREMENT :

Identifies process improvement opportunities for platform work as an example, review SQM and QA reports, review trends to identify process improvement and automation)
Gather, process FCR and QA performance data and conduct trending and root cause analyses
Design and develop standard reports for metrics reporting and analysis. Document call center processes using standard techniques.

Disclaimer:

This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

Education/Experience:

High School Diploma/GED required.
Minimum of four (4) years' experience in an operational role, or analytical role.

Knowledge:

Knowledge of Healthcare industry preferred.
Strong Computer Skills-Microsoft Office products to include (Access, Word, Excel, PowerPoint, Project, Visio, etc.) is Required.
Team Player, Strong Analytical and Interpersonal Skills.

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware

Salary Range:

$69,500 - $93,030

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

Disclaimer:
This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

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