Self-Direction PPP Support Counselor (Field Based - Somerset County)

Job description

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. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. About the Role The Self-Direction PPP Support Counselor is responsible for conducting quarterly in-person evaluations on members enrolled in the Personal Preference Program. During these quarterly meetings, the Support Counselor is responsible for all workforce functions including budgeting, back-up plan, capacity planning, forecasting, safety planning, scheduling and real time monitoring. The Support Counselor will provide member assistance and strategic insight during the development and review of the member’s cash management plan, budget performance, review of monthly results and to ensure the cash management plan is meeting the member’s needs. What You'll Do Work with 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 their daily needs. Review monthly cash expenditures to ensure the member is within monthly budget allowance. Review monthly budget on a quarterly basis and update, as needed. Develop and review 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 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 note must be completed during the time of visit and uploaded on the day of the participants’ visit. Educate members on notification requirements for changes in condition, hospitalizations or caregiver issues. Provide education on safety tips including but not limited to fall risk prevention. Provide clear and consistent communication. Perform other relevant tasks as assigned by management. What You Bring Education/Experience: 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: 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. Skills and Abilities: Demonstrate strong analytical skills with emphasis on forecasting. Ability and willingness to learn new software applications. Skills in problem solving, judgment, critical thinking and decision making. Ability to be highly organized with an emphasis on accuracy and timeliness. Ability to organize information and have attention to detail and accurately follow procedures. Ability to work alone with minimum supervision and with others in a team environment, occasionally under time pressure and on several tasks at the same time. Ability to visit a diverse population of participants in their homes, which may encompass a wide range of home settings. Ability to assume an increased home visit schedule (i.e., greater than 60% of working hours) as dictated by business needs. Ability to organize home visit caseload to ensure efficient use of driving time. Why Horizon? At Horizon, you’ll do meaningful work that directly improves lives—while being supported by a mission‑driven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too. If you are passionate about making an impact, we’d love to hear from you! Salary Range: $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 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 Disclaimer: Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. 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. 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.