Self-Direction PPP Support Counselor (Ocean County)

Horizon Healthcare Services•Hopewell, NJ

About The Position

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. The Self-Direction PPP Support Counselor is responsible for conducting quarterly in-person evaluations on members enrolled in the Personal Preference Program within Ocean County. 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. 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.

Requirements

High School Diploma/GED 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.
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.
Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware

Nice To Haves

LPN or healthcare background preferred
Equivalent and relevant professional experience in budgeting or finance preferred but not required

Responsibilities

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.