RN I (CCR)

Horizon-Blue Cross Blue Shield New Jersey
Trenton, New Jersey
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 continuum of care. Per...

Posted: Today

Credit Balance Audit Support

Horizon-Blue Cross Blue Shield New Jersey
Newark, New Jersey
Job Summary: This position is responsible for the administration of activities related to the onsite credit balance audit function. In addition, this position supports internal departmental functions...

Posted: Today

Mgr, MLTSS Network Relations & Contracting

Horizon-Blue Cross Blue Shield New Jersey
Ewing Township, New Jersey
Job Summary: This position is responsible for developing and managing the contracting arrangements between HNJH and assigned Managed Long Term Support and Service (MLTSS) provider networks to enhance...

Posted: Today

RN I

Horizon-Blue Cross Blue Shield New Jersey
Trenton, New Jersey
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 continuum of care. Per...

Posted: Today

Outpatient Hospital Field Auditor II

Horizon-Blue Cross Blue Shield New Jersey
Newark, New Jersey
Job Summary: This position performs and finalizes third party, outpatient APC & bill verification (CPT 4 coding experience required), credit balance and Ambulatory Surgery Center facility audits and ...

Posted: Today

Graphic Designer III

Horizon-Blue Cross Blue Shield New Jersey
Newark, New Jersey
The Graphic Designer III is responsible for designing the look and feel of new and revised printed and electronic collateral and sales materials for all stakeholders. The position also maintains and u...

Posted: Today

Managed Care Coordinator I

Horizon-Blue Cross Blue Shield New Jersey
Newark, New Jersey
Job Summary: This position supports the Health Services and Utilization Management functions and acts as a liaison between Members, Physicians, Delegates, Operational Business members and Member Serv...

Posted: Today

IT Security Analyst IV

Horizon-Blue Cross Blue Shield New Jersey
Newark, New Jersey
Job Summary: This position is a lead security analyst within IT Security Governance and IT Security Operations. Responsibilities: IT Security Operations Monitor the effectiveness of the Enterprise...

Posted: Today

Pharmacy Specialist I

Horizon-Blue Cross Blue Shield New Jersey
Trenton, New Jersey
Job Summary: In a call center environment, this position is responsible for receiving verbal and written requests for prior authorization from pharmacists, physicians and/or patients and is responsib...

Posted: Today

RN I (GEMS)

Horizon-Blue Cross Blue Shield New Jersey
Trenton, New Jersey
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 continuum of care. Per...

Posted: Today

Solution Design Engineer

Horizon-Blue Cross Blue Shield New Jersey
Newark, New Jersey
Job Summary: At Horizon Blue Cross Blue Shield Sales Portal platform is developed using IBM Websphere Portal, IBM WebShpere Application Server, IBM WebShpere Content Management and IBM WebShpere Comm...

Posted: Today

Care Specialist II (Northern NJ)

Horizon-Blue Cross Blue Shield New Jersey
Trenton, New Jersey
Job Summary This position is accountable for the management of high risk level cases identified through the care management program to ensure effective implementation of interventions, and to ensure ...

Posted: Today

Appeals Resolution Analyst

Horizon-Blue Cross Blue Shield New Jersey
Trenton, New Jersey
Job Summary: This position is responsible for the efficient functioning of the appeals resolution correspondence unit. This position is responsible for basic appeals resolutions and administrative ap...

Posted: Today

Director, Benefits Management Systems

Horizon-Blue Cross Blue Shield New Jersey
Newark, New Jersey
Job Summary: The Director, Benefits Management ensures the systems and interfaces required for the data integrity of benefits are implemented from an end to end perspective. This includes portal, Cen...

Posted: Today

Group Underwriter I

Horizon-Blue Cross Blue Shield New Jersey
Newark, New Jersey
Job Overview: This position provides Rating & Underwriting services and support to the Sales team and is responsible for the production of rates for the 51+ markets. Major Responsibilities: Develop...

Posted: Today