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

Job Summary:

Responsible for the general operational oversight of multiple disciplines/units to ensure enterprise and divisional performance goals are achieved.

Job Responsibilities:

• Direct staff to ensure overall client satisfaction and appropriate level of service delivery.
• Develop and monitor goals for staff and provide ongoing feedback and coaching.
• Manage staff, including individual contributors and supervisors including; succession planning, talent acquisition, retention, development, annual performance evaluations, skills assessment, training and matters of compensation.
• Evaluate and modify business models (i.e., inventory data, staffing levels, hiring plan analysis and results, budget allocation and resources).
• Identify opportunities and implement process improvements (i.e., root cause analysis, technological assessments, etc.) to optimize performance and administrative cost.
• Create an environment that fosters a positive experience for employees, internal and external customers.
• Responsible for timely adherence with compliance, training and reporting requirements as determined by internal and external regulatory/accreditation agencies and policies.
• Ensure staff comprehends and complies with; best practices, professional standards, internal policies and procedures.
• Administer and monitor Service Level Agreements (SLAs) with appropriate business partners.
• Lead or participate in both internal/external workgroups/committees, maintain internal/external business partnerships and represent department/enterprise where appropriate.
• Perform other related tasks as assigned or required by operational need.
• Accountable for maintaining effective internal controls over the processes and transactions under areas of responsibility including the completeness and accuracy of financial information and transactions, compliance with applicable laws and regulations, and the effectiveness and efficiency of operations.

Addendum for Ops, Admin & Reporting:

• Manages a team of technical analysts who are responsible for Ncompass Tableau reporting across and in support of other Horizon Divisions.
• Oversees the planning, execution, and completion of technical analysis projects. Allocates resources to ensure project deliverables and deadlines are met and are within budget. Collaborates cross-functionally to gather requirements, develop solutions, and make recommendations to internal stakeholders.
• Develop and implement analytical frameworks and methodologies. Conduct in-depth technical analysis on data sets, models, and systems. Prepare and present findings to stakeholders.
• Implement quality control processes and standards. Ensures the accuracy, integrity, and quality of testing and technical analysis outputs. Validate analysis results for relevance, prepare reports and present findings to stakeholders. Identify risks related to technical analysis projects and develop contingency plans to mitigate and address potential issues. Ensure compliance with regulatory requirements and data privacy standards.

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
• Bachelor degree preferred or relevant experience in lieu of degree
• Three (3) years of supervisory experience.
• Five (5) years operations experience required.

Knowledge/Skills:

• Healthcare Industry, Technology, Business Management, Microsoft Office.

Salary Range:

$94,900 - $129,570

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

Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

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.