Network Outreach Specialist I

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 This position is responsible for gathering attestation and validation on the accuracy of provider network data as displayed in our local directories to ensure they have the ability for the services, benefits, and programs as well as understand their rights and responsibilities. This position is also responsible for compliance for all DOBI, CMS and NCQA accuracy regulations. What You'll Do Responsibilities: Makes outbound validation calls to providers in order to assure of demographic practitioner detail for each practice location for all Horizon networks. Contacts members regarding preventive health activities. Receives inbound services calls and provide accurate complete information in response to provider inquiries, complaints and problems within a timely fashion. Contact provider offices to encourage ongoing education