Contract Analyst II

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

Job Summary:

Responsibilities:

• Develops, reviews, updates and issues contracts and booklets which legally define benefit obligations to individual subscribers, groups, other Blue Cross/Blue Shield Plans, or subsidiaries, where applicable.

• Works with benefits repository system to load and maintain benefit features, where applicable.

• Customizes contracts and booklets with group specific benefits, possibly updating text and performing special edits to document libraries.

• Prepare for benefit changes not presently incorporated in Horizon's existing benefit outlines.

• Provides contract documentation and interpretation of contractual benefits and administrative provisions.

• Prepares riders for benefit changes not presently incorporated in Horizon's filed contracts.

• Prepares Summary Plan Descriptions for self-insured business where applicable.

• Conducts daily audits for contracts and booklets where applicable.

• Collect data from various account contracts as needed by other plan areas

• Meets with account executives to discuss account benefit needs and to ensure proper administration.

• Responds to Request for Proposal (RFP) requests where applicable.

• Participates in cross-divisional workgroups as designated.

• Completes other assigned functions as requested by Management.

Disclaimer:
This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of
colleagues assigned to this job.

Education/Experience:

• High School diploma/GED required.

• Requires minimum three (3) years experience in the health insurance industry.

• Prefer health insurance contract/product experience.

• Prefer working knowledge and experience with Document Management System (DMS).

Knowledge:

• Requires working knowledge of personal computers and supporting software in windows based environment including MS Office Products and email application systems.

• Prefer knowledge of health insurance products.

• Prefer knowledge of federal and state health law and underwriting regulations.

Skills and Abilities:

• Requires excellent research skills.

• Attention to Detail

• Analytical & Problem Solving

• Adaptability/Flexibility

• Results-Oriented

• Planning/Priority Setting

• Information/Knowledge Sharing

• Functional/Technical Job Skills

Salary Range:

​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 but not limited to: education, experience, licensure, certifications, geographic location, and internal equity.  This range has been created in good faith based on information known to Horizon at the time of posting.  Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:

• Comprehensive health benefits (Medical/Dental/Vision)

• Retirement Plans

• Generous PTO

• Incentive Plans

• Wellness Programs

• Paid Volunteer Time Off

• Tuition Reimbursement

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 or status as an individual with a disability and any other protected class as required by federal, state or local law.  Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.