Horizon Blue Cross Blue Shield of New Jersey · 18 hours ago
Behavioral Health Network Specialist
United States
Full-time
Remote
Senior Level
$79K/yr - $106K/yr
5+ years expHorizon Blue Cross Blue Shield of New Jersey empowers its members to achieve their best health and has been a leader in health solutions for over 90 years. The Behavioral Health Network Specialist is responsible for outreach, recruitment, and relationship management within the behavioral health practitioner community, ensuring effective communication and problem resolution.
HealthcareHealth Care
Responsibilities
Serves as the key external-facing member of the behavioral health network management team for the behavioral health professional network in their designated geographic area
Analyzes membership and geographical access by BH Specialty to determine specific goals and action plans for targeted recruitment of new practitioners, providing blueprint for contracting priorities and network growth targets
Performs activities that develop prospective relationships with providers by supporting and participating in the recruitment and maintenance of the behavioral health provider network. Provides input to behavioral health special payment arrangement contract renewals to improve the services that will maximize the potential for retention and initial provider enrollment
Informs and educates behavioral health practitioners on Horizon‘s products and services and is held accountable for influencing and accelerating the network adoption of related Horizon strategic efficiency initiatives including provider portal adoption and other self-service or automation related objectives. Engages in proactive outreaches to high volume behavioral health groups in their designated territories to build rapport and ensure providers are aware of any pertinent updates
Analyzes provider related information and data in order to recommend actions and solutions to strengthen the provider’s relationship with Horizon
Initiates communication with other members of BH network management team and representatives from appropriate areas to effectively troubleshoot complex claim situations, program/policy disputes, executive, and VIP and Regulatory inquiries to drive resolution and improve service quality
Alerts leadership to potential issues risks, and opportunities identified through behavioral health network interactions
Plans, organizes, and presents seminars to various BH network practitioners and groups, billing services, medical societies and internal groups
Maintains a thorough knowledge of healthcare industry trends and developments through the review of industry publications, newsletters and formal training
Identifies, researches, recommends and implements potential saving opportunities for the delivery of cost-effective and quality care that subsequently results in the generation of cost savings
Works closely with BH Network Leadership and BH network practitioners to facilitate dialogue pertaining to practice patterns and BH quality/outcomes measures
Drives communication with pertinent staff and managers to ensure that interdependencies between the departments, other projects and functional work are accurately identified and addressed, and provides status reports to management
Qualification
Required
High School Diploma/GED required
Requires a minimum of five (5) years healthcare experience, preferably with provider or client focus/interaction
Requires knowledge of healthcare industry
Requires knowledge of New Jersey behavioral health provider community
Preferred
Bachelor degree preferred or relevant experience in lieu of degree
Candidates with current or previous Behavioral Health experience including providers and facilities outreach and provider/network recruiting strongly preferred
Prefers behavioral health related experience in the healthcare/insurance industry
Prefers knowledge of HBCBSNJ programs, products and procedures
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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