Company: Horizon Blue Cross Blue Shield of New Jersey
Posted on: January 28, 2023
Horizon BCBSNJ employees must live in New Jersey, New York,
Pennsylvania, Connecticut or Delaware
This position serves as Horizon's on-site representative at the
vendor(s) location or Horizon office based representative working
collaboratively with the vendor(s) management staff to ensure that
exceptional service is given to our customer. The incumbent
facilitates the day- to-day coordination of the vendor(s) customer
service and claims operations with Horizon operations.
- Acts as the liaison between Horizon-BCBSNJ and the vendor(s) to
address day-to-day operational issues.
- Identifies and implements process improvements targeted to
improve operational efficiencies and delivery of customer
- Coordinates the delivery of training and education to the
vendor(s) to ensure adherence to Horizon business and compliance
- Requests and evaluates Corrective Action Plans for adequacy,
works with vendor on required changes, communicates approval of CAP
to the vendors, and monitors open Corrective Action Plans.
Coordinates guidance, coaching, refresher training and instructions
to the vendor(s) staff in order to improve their performance.
- Standardizes workflows and business processes to ensure
compatibility between the Plan and Vendor teams to increase
efficiencies. Prepares status reports to keep Horizon management
team apprised of daily operations, progress and issues.
- Assists in the timely resolution of escalated customer
- Facilitates the resolution of system problems, creating and
tracking P-Logs and escalate when required.
- Monitors inventory levels and assists with developing action
plans to keep within acceptable levels.
- Facilitates meetings/workgroups to drive issue resolution and
The information above is intended to describe the general nature of
the work being performed by each incumbent assigned to this
position. This job description is not designed to be an exhaustive
list of all responsibilities, duties, and skills required of each
- Prefers Bachelors degree from an accredited college or
university, preferably in business administration field. In lieu of
a degree, applicant must have 4 additional years of equivalent and
relevant work experience.
- Requires a minimum of 4 years of experience in vendor
management field or relevant field.
- Requires a minimum of 3 years health care operations
Additional licensing, certifications, registrations:
- Requires valid drivers license and access to a car.
- Demonstrates knowledge, understanding and conforms to laws,
regulations and policies that pertain to the organizational units
- Requires general knowledge of tasks performed by areas that
support the business teams.
- Requires project management skills.
Skills and Abilities:
- Must have effective verbal and written communication
- Demonstrated ability to deliver highly technical information to
less technical individuals.
- Proven time management skills with the ability to manage
multiple priorities or tasks.
- Ability to work in a production focused environment.
- Exercise sound judgment and strong problem solving skills.
- Proven ability to ask probing questions and obtain thorough and
- Must be client service focused with effective ability to
- Must be detail oriented with strong organizational and data
processing skills. Proven ability to follow detailed instructions
is essential, along with excellent math skills.
- Strong analytical, research and problem solving skills a
- Must function as a self-starter working effectively working
across functional lines.
Travel (If Applicable):
- Requires up to 40% travel domestic and international as
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.
Keywords: Horizon Blue Cross Blue Shield of New Jersey, Newark , Vendor Liaison, Other , Newark, New Jersey
Didn't find what you're looking for? Search again!