Horizon Blue Cross Blue Shield of New Jersey · 12 hours ago
Quality Outreach Specialist
United States
Full-time
Remote
Mid Level
$70K/yr - $94K/yr
3+ years expHorizon Blue Cross Blue Shield of New Jersey empowers its members to achieve their best health and is seeking a Quality Outreach Specialist. This position is responsible for coordinating, implementing, and monitoring outreach and interventions to improve HEDIS performance by collaborating with various stakeholders.
Health Care
Responsibilities
Collaborate in designing, implementing, and monitoring all outreach and intervention progress with management
Builds and maintains relationships with Member Experience, PC&S, Govt. Program Communications, Enterprise Communications, Analytics, as well as external vendors to assist in implementing all initiatives to improve HEDIS performance
Support manager in monitoring initiatives and performance for all vendors and make sure initiatives are within budget and consistent with expectations to improve performance
Collects, analyzes and synthesizes data for the development of materials to guide departments decision making for Medicare and Medicaid populations' health management, cost of health care management, and quality of care
Compile comprehensive monthly, quarterly, annual reports to summarize the efficacy and impact of all interventions to assist with strategic approach to improve HEDIS performance. Includes developing summary documents and reports related to provider outreach, engagement, and intervention activities
Participates in outreach activities for the program as appropriate. Develops outreach and in-reach materials to promote services
Facilitate and participate in meetings and presentations with internal and external audiences
Performs other related duties as assigned or directed
Qualification
Required
High School Diploma/GED required
Requires a minimum of 3 years experience in Population Health Management or 3 years of experience with social determinants of health for behavioral health
Experience and understanding of NCQA, HEDIS, or URAQ standards
Requires 3 - 5 years managed care experience
Requires knowledge of health care delivery systems, distribution channels, health care industry and health insurance industry
Knowledge of applicable laws and regulations as well as of Governmental Agencies and Regulatory
Requires knowledge of HEDIS, CAHPS, and Stars for CMS
Knowledge of quality improvement methodology
Knowledge of PC's and applicable software application
Requires excellent written and oral communication skills
Requires demonstrated aptitude for analytical thinking and ability to report findings accurately
Requires strong interpersonal, organizational and problem solving skills
Requires strong project management skills
Requires strong relationship building skills to work collaboratively across departments/divisions
Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint); Should be knowledgeable in the use of intranet and internet applications
Some travel required
Preferred
Prefers knowledge of user-oriented programming languages including SAS, SQL
Benefits
Comprehensive health benefits (Medical/Dental/Vision)
Retirement Plans
Generous PTO
Incentive Plans
Wellness Programs
Paid Volunteer Time Off
Tuition Reimbursement
Company
Horizon Blue Cross Blue Shield of New Jersey
Horizon Blue Cross Blue Shield of New Jersey is a company that provides health insurance products.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Gary St. Hilaire
President & Chief Executive Officer
Recent News
2026-01-06
2025-12-29
2025-12-25
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