Behavioral Health Network Specialist
NJM Insurance Group
full-time
Posted on:
Location Type: Hybrid
Location: Hopewell • New Jersey • United States
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Salary
💰 $79,100 - $105,945 per year
About the role
- 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
- 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
- Informs and educates behavioral health practitioners on Horizon's products and services
- Engages in proactive outreaches to high volume behavioral health groups in their designated territories
- Analyzes provider related information and data to recommend actions and solutions to strengthen the provider’s relationship with Horizon
- Initiates communication with other members of BH network management team to effectively troubleshoot complex claim situations
- 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
- Maintains a thorough knowledge of healthcare industry trends and developments
- Identifies, researches, recommends and implements potential saving opportunities for the delivery of cost-effective and quality care
Requirements
- High School Diploma/GED required
- Bachelor degree preferred or relevant experience in lieu of degree
- Requires a minimum of five (5) years healthcare experience, preferably with provider or client focus/interaction
- Prefers behavioral health related experience in the healthcare/insurance industry
- Requires knowledge of healthcare industry
- Requires knowledge of New Jersey behavioral health provider community
- 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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Soft Skills
relationship buildingcommunicationorganizational skillsanalytical skillsproblem-solvingpresentation skillsproactive outreachteam collaborationleadershiptroubleshooting
Certifications
High School DiplomaGEDBachelor's degree (preferred)