Self-Direction PPP Counselor; Cumberland

Overview

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. We strive to maintain an innovative and inclusive environment that allows employees to thrive.

The Self-Direction PPP Support Counselor conducts quarterly in-person evaluations for members enrolled in the Personal Preference Program. During quarterly meetings, the Support Counselor handles workforce functions including budgeting, back-up planning, capacity planning, forecasting, safety planning, scheduling, and real-time monitoring. The counselor provides member assistance and strategic insight during the development and review of the member's cash management plan and budget performance, and ensures the plan meets the member’s needs.

• Work with the member to develop a cash management plan that is member-specific, member-choice, and member-centric; enabling the member to use their budget to meet daily needs.
• Review monthly cash expenditures to ensure the member remains within the monthly budget allowance.
• Review monthly budget on a quarterly basis and update as needed.
• Develop and review the member's back-up plan on a quarterly basis.
• Review worker timecards to analyze PTO submissions, EVV compliance, and hours of work.
• Update and maintain the member's electronic medical record.
• Identify, report, and follow up on allegations or reports of suspected fraud, waste, neglect, or abuse.
• Identify and maintain available community resources and other services.
• Maintain timely documentation: in-home visits notes must be completed during the time of visit and uploaded on the day of the participant's visit.
• Educate members on notification requirements for changes in condition, hospitalizations, or caregiver issues. Provide education on safety tips including fall risk prevention.
• Provide clear and consistent communication.
• Perform other relevant tasks as assigned by management.

• High School Diploma/GED required.
• LPN or healthcare background preferred.
• Equivalent and relevant professional experience in budgeting or finance preferred but not required.
• Minimum of 3 years' experience in a health insurance industry or professional business-related field required.
• Experience with MS Office and other WFM solutions highly preferred.

• Knowledge of Healthcare industry helpful.
• Ability to balance multiple priorities.
• Team player, strong analytical and interpersonal skills.
• Proficient in MS Word, MS Excel and MS PowerPoint.

• Demonstrate strong analytical skills with emphasis on forecasting.
• Ability and willingness to learn new software applications.
• Problem solving, judgment, critical thinking and decision making.
• Highly organized with an emphasis on accuracy and timeliness.
• Attention to detail and ability to follow procedures.
• Ability to work independently with minimal supervision and in a team environment, occasionally under time pressure.
• Ability to visit a diverse population of participants in their homes, which may encompass a wide range of home settings.
• Ability to handle an increased home visit schedule (greater than 60% of working hours) as dictated by business needs.
• Ability to organize home visit caseload to ensure efficient use of driving time.

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

$63,000 - $84,420

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 education, experience, licensure, certifications, geographic location, and internal equity. This range is provided in good faith based on information known pensation decisions depend on the circumstances of each case. Horizon offers a comprehensive compensation and benefits package including:

• Comprehensive health benefits (Medical/Dental/Vision)
• Retirement Plans
• Generous PTO
• Incentive Plans
• Wellness Programs
• Paid Volunteer Time Off
• Tution Reimbursement

This job summary indicates the general nature and level of work performed. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required.

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, disability, or any other protected class as required by law. Reasonable accommodation requests will be considered as part of the recruiting and hiring process.