Mgr, Medical Cost Mgmt job in Newark
Newark, New Jersey - NJ Horizon Blue Cross Blue Shield of New Jersey
Job Ref: | 2019-7714 |
Employer: | Horizon Blue Cross Blue Shield of New Jersey |
Sector: | Health Insurance |
Qualifications: | Unclassified |
Software: |
Excel
SAS SQL |
Job Type: | Full Time |
Salary and Benefits: | $106,400 - $145,215 per year |
Remote: | Yes |
Location | |
Country: | United States |
State/Province/County: | New Jersey - NJ |
City: | Newark |
Post Code: | Not specified |
Map: | |
Description | |
Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware Job Summary: Responsible for managing multiple aspects of the Enterprise medical costs structure including both on-system and off-system medical costs and directly lead efforts across the Enterprise to provide and present meaningful medical cost trend analysis to drive opportunities and decision making. Collaborate with multiple Commercial and Government Program business partners, including both clinical and financial, to drive the Medical Cost Trend Committee with the goal of identifying emerging business trends and the development of medical cost action plans. Key focus areas will include directly managing the Government Programs payment cycle for various provider incentive programs and other value based payment programs including shared risk programs, ensuring that necessary internal controls are implemented and working effectively and Government value based programs are administered within financial expectations, leading the Medical Cost Trend Committee, developing the underlying assumptions and business commitments to support all medical cost budgeting and forecasting activities, and for the financial oversight of the Enterprises Behavioral Health Program.Responsibilities:
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:
Additional licensing, certifications, registrations:
Knowledge:
Skills and Abilities:
Travel:
Salary Range: $106,400 - $145,215 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:
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. |
ref: (2019-7714) 3 hours ago
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