Quality Management Coordinator

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.

• Inputs, updates and appropriately transfers member and clinical data for Quality databases.

• Provides routine typing, copying and phone support to the Quality Management department to facilitate accurate, complete and timely communication of information.

• Maintains and updates computerized, storage room and archived files and records according to unit needs.

• Manipulates software and databases to obtain, and organize pertinent information utilized by Quality Management Coordinators in decision making and reporting.

• Compiles, tabulates and prepares for analysis of specific data on Quality Improvement activities.

• Communicates verbally, in writing and by electronic mail with internal and external customers involved in Quality Management activities.

• Performs special projects, surveys and studies to meet Quality Management unit goals, as assigned by and under the direction of the Quality Management Manager.

• Responsible for productivity and timeliness of meeting expected and identified individual work process goals

• Manages ongoing activity and updates for all Quality Management Policies to maintain the highest level of compliance, including monitoring of policy changes and renewals.

• Ensure QM Department and Health Service policies are tracked, and reviewed on a timely basis via the HS policy work group.

• Creates and manages multiple project plans with tasks coordinated across QM and other departments at all levels of the organization

• Coordination of materials for the Quality Improvement Committee including preparation of minutes, agenda, attendance records and meeting materials.

• Coordination of materials for the health service policy workgroup including preparation of minutes, agenda, attendance records and meeting materials.

• Participates in internal and external meetings as needed Obtain information, create status reports, respond to inquiries or projects as directed

• May serve as liaison/coordinator for special projects or workgroups

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.

• High School Diploma/GED required.

• Prefer a minimum of one (1) year office experience within health care.

• Prefer one (1) year managed care experience in a customer-oriented capacity.

• Prefer exposure to data compilation and presentation processes.

• Requires knowledge of managed care health care delivery systems.

• Requires strong PC skills with a demonstrated accuracy, timeliness and completeness.

• Requires solid organization of multiple tasks, time and work processes

• Requires good organizational skills.

• Requires good verbal and written communication skills.

• Requires good PC skills and application of software

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

Salary Range:

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

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.

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.