This position is responsible for overseeing contracts between hospitals in the Select Hospital Network or ancillary contracts (i.e. SNF's Sub acute, Home IV, etc.) and Horizon Blue Cross Blue Shield, and for ensuring that the contractual arrangement is fulfilled. Accountability's may include developing, negotiating and managing the ancillary contracting arrangements. In a

The Data Analyst leads the technology process for the end to end Risk Adjustment Processing System (RAPS) and Encounter Data Processing System (EDPS) data flow and works within key regulator guidelines for acceptable data submission. Using SQL and SAS programs lead the gathering of data for submissions Risk Adjustment. As the senior analyst of data, will be responsible fo

The Identity and Access Management (IAM) Engineer will collaborate cross functionally with Security Architects, Senior Infrastructure Analysts, and Senior Application Developers to provide a stable WAM environment by applying new and best practices in Identity and Access Management and Customer IAM technologies to support business applications. This position will be respo

This position contributes to Quality Improvement efforts through the research, analysis, design, programming, implementation and coordination of accurate and timely reporting. The incumbent will partner with multiple customers across the Enterprise to provide complex resolutions to analytics/data problems and will provide reporting/analytic deliverables (i.e. tables, grap

The role is a technical lead that requires deep knowledge, skills, and experience in designing and carrying out clinical analytics. The position is a key team member collaborating in a multi disciplinary business environment with colleagues across the enterprise to lead clinical performance analytics, development, and reporting that deliver actionable clinical insights to

Reporting directly to an Audit Manager, responsibilities include developing the scope of audits, programs or initiatives, executing testing and reporting in a quality manner, and the identification as well as tracking of issues to closure. Responsibilities Executes assigned planning, data gathering, analysis and testing tasks independently and in the timeframe established

Job Summary Data analysts are experts with strong understanding of data structures and analysis. They are responsible for ensuring requirements around the accuracy, quality, completeness, and timeliness of data are captured and understood. They work hand in hand with Data Modelers, Data Developers, Data Stewards and Business SMEs to ensure the customers data needs are acc

This position is responsible for individual account sales, received from clients responding to promotional materials and phone inquiries. Informs and educates clients on select HZN products and services Ensures clients are informed of relevant legislative and regulatory issues and their associated impact Facilitates the enrollment process for new individual sales. Ensures

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. Performs duties and types of care management as assigned by management. Serves as mentor/trainer to new RN's and other staff as needed. Subject matter expert for the various projects and com