Strategic Client Solutions Specialist

Horizon Blue Cross Blue Shield; Newark, Northern (NJ, KY); Hybrid; USD 98,000 - 133,000; Full time

Benefits offered by this job

Comprehensive health benefits (Medical

Dental/Vision benefits

Retirement Plans

Generous PTO

Incentive Plans

Wellness Programs

Paid Volunteer Time Off

Tuition Reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a Key Client Support Specialist to provide subject matter expertise to SHBP account teams, focusing on underwriting, billing operations, and market dynamics. You will lead billing accuracy, forecasting, and plan design translation of state laws.

The role emphasizes vendor integrations, stakeholder management, and developing strategic plans to retain and grow SHBP membership and revenue, with remote work options and NJ-based flexibility.

Qualifications

• Prefers Bachelor's degree from an accredited college or university.
• Requires a minimum of 10 years of experience in group health.
• Experience in a fast paced, performance driven environment necessary.
• Knowledge of complex billing operations preferred.

Responsibilities

• Provides subject matter support to account management teams in areas related to underwriting, ancillary products, benefit design, and market-specific dynamics.
• Serve as the subject matter expert for billing operations, ensuring accurate billing administration and timely resolution of billing inquiries and discrepancies.
• Maintain accurate and updated billing master roster.
• Develop and maintain monthly, quarterly, and annual forecasts, identifying trends, variances, risks, and opportunities impacting financial performance.
• Support of plan design implementations, ensuring accurate translation of State legislation into business requirements.
• Act as the business lead for vendor integrations serving State members.
• Serves as a liaison for account management team and other support areas within the organization that impact client management.
• Manage database of individual stakeholders within the market and their connections.
• Provides assistance in developing strategic business plan to retain and grow within the SHBP Plan.
• Train newly hired staff on the unique SHBP Market.

Skills

Underwriting

Billing operations

Forecasting

Vendor integrations

Relationship management

Market strategy

Stakeholder management

Education

Bachelor's degree

Tools

Windows

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a Key Client Support Specialist to provide subject matter expertise to SHBP account teams, focusing on underwriting, billing operations, and market dynamics. You will lead billing accuracy, forecasting, and plan design translation of state laws.

The role emphasizes vendor integrations, stakeholder management, and developing strategic plans to retain and grow SHBP membership and revenue, with remote work options and NJ-based flexibility.