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

Job Summary :

This position is accountable for actively performing retention outreach to members as assigned and are responsible for providing an array of special services to new and existing members to maximize the potential for retention, new individual sales and expansion of community relationships.

Activities included but are not limited to, conducting member retention education, various outreach calls, presentations at meetings, data collection, and trending that will identify risk areas for disenrollment and assist in retention strategies coordination.

Job Responsibilities :

• Develop retention strategies for evaluation of activities targeted to the Medicare D-SNP population.
• Serves as a representative at company community events and coordinates all on site responsibilities (must be available to work occasional evenings and weekends.)
• Receives member inquiries via on site events, probe for additional information to accurately document inquiries for resolution handling and utilize available resources to quickly and efficiently resolve or redirect inquiries in accordance with prescribed departmental process.
• Responsible for educating and enrolling potential members into Horizon products and follow up on new member applicants.
• Receive incoming referral calls and emails from member services and / or case management to assist member with retention queries / direct call as needed (disenrollment process).
• Conduct member retention outreach calls to members as assigned.
• Produce detailed reporting and analyses weekly and monthly of Renewal, Involuntary and Voluntary disenrollment outreach campaigns.
• Develop ad-hoc reports when needed.
• Transporting, maintaining and operating the company vehicle (van / mobile van) at all company events.

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.
• 5 years relevant work experience in Medicaid and Medicare managed care markets.
• Prefers two years work experience in community health, Medicare or health insurance environment.

Additional Licensing, Certifications, Registrations :

• Requires NJ Health Insurance Producer License
• Requires a valid NJ driver’s license

Knowledge :

• Requires knowledge of Managed Care in NJ, its industry principles and concepts.
• Requires knowledge of PCs and windows based software applications.
• Knowledge of NJ Medicaid, uninsured and Medicare D-SNP population desired.

Skills and Abilities :

• Requires bilingual skills (Spanish / English).
• Excellent written and verbal communication skills.
• Requires the ability to operate and maintain the company vehicle (26’ van / mobile van) at company events, as necessary.
• Excellent Customer Service skills including the ability to manage and diffuse irate members.
• Ability to prioritize and to multi-task in a fast-paced environment.
• Ability and willingness to work as a team player.

Travel (If Applicable) :

This position requires travel to all 21 counties in the state of NJ.Evenings and weekends may be required.

Salary Range : $68,500 - $91,665

$68,500 - $91,665

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.

Comprehensive health benefits (Medical / Dental / Vision)

Retirement Plans

Generous PTO

Incentive Plans

Wellness Programs

Paid Volunteer Time Off

Tuition Reimbursement

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.

Last updated : 2024-06-25