Job Location: Newark, NJ
Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware
Job Summary:
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.
- 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.
ADDENDUM FOR QUALITY AUDIT MEASUREMENT TEAM:
- 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.
Education:
- High School Diploma or GED equivalent required. Bachelor’s degree or relevant job experience preferred.
Experience:
- 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.).
- Team Player, Strong Analytical and Interpersonal Skills.
Travel:
- Some travel may be required.
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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