Account Manager IV

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 retaining existing accounts and selling additional product lines, where appropriate and profitable, within the Labor market segment. The Account Manager for the Labor market serves as the primary relationship manager for assigned labor union health and welfare funds and gaming accounts. This role is responsible for account retention, operational excellence, and strategic support across complex, self-funded and fully insured labor groups. The Account Manager acts as a trusted advisor to fund trustees, administrators, TPAs, and consultants while coordinating across internal Horizon teams to ensure service delivery, compliance, and performance expectations are met. Labor accounts have unique governance, regulatory, and service requirements, requiring an elevated level of expertise, responsiveness, and relationship management.
What You'll Do

• Manage contract renewals, including negotiating terms and approving contract modifications outside standard guidelines to support retention and growth.
  
• Assess client needs and recommend appropriate products, including identifying opportunities to sell additional lines of business.
  
• Proven approach to developing and maintaining trusted relationships across Labor stakeholders.
  
• Serve as the day-to-day account lead, maintaining consultative relationships with administrators, TPAs, brokers, and consultants.
  
• Monitor service performance, contractual obligations, and performance guarantees where applicable.
  
• Support renewal strategy, including plan design changes, pricing discussions (in partnership with Sales), and benefit modifications
  
• Represent Horizon at trustee meetings, board meetings, and client requested forums.
  
  
• Proactively manage client expectations and escalate issues as appropriate to ensure timely resolution.
  
• Partner with Data & Reporting teams to deliver client specific reporting and performance insights.
  
  
• Coordinate internally with Service, Claims, Provider Contracting, Network, Finance, Compliance, IT, and Vendor partners to resolve complex issues.
  
• Lead discussions related to claims, eligibility, billing, stop-loss coordination, provider network issues, and escalations
  
• Analyze relevant factors and outcomes to make binding financial, operational, and service-related decisions.
  
• Financial focus on managing account performance, forecast and financial outcomes.
  
• Perform additional duties as assigned by management
  

What You Bring

Education/Experience:

• High School Diploma or GED required.
  
• Bachelor's degree preferred, or equivalent relevant experience in lieu of a degree.
  
• Minimum of ten (10) years of account management experience with increasing responsibility, including strategic client relationship management, contract negotiation, and renewal optimization, preferably within the health insurance industry.
  
• Sales and/or Account Management experience within Labor and Public Sector markets strongly preferred.
  
• Experience with ASO groups both Full Administration and Shared Administration preferred.
  

Additional licensing, certifications, registrations:

• Requires a New Jersey State Health/Life License.
  

Knowledge:

• Advanced proficiency in personal computers and Windows-based software, including Microsoft Word, Excel, and PowerPoint; familiarity with intranet and internet applications.
  
• Knowledge of union structures, Shared Administration/TPA models, and collective bargaining agreements.
  
• Understanding of group health product lines, including Managed Care.
  
• Knowledge of rating processes and policy renewal practices.
  
• Preferred knowledge of Horizon BCBSNJ products, underwriting policies, enrollment, billing, and claims processing procedures
  

Skills and Abilities:

• Strong negotiation skills.
  
• Ability to tailor communication and messaging to various audiences.
  
• Ability to effectively leverage limited engagement opportunities with key decision-makers.
  
• Capability to communicate complex concepts in a clear, concise manner.
  
• Excellent verbal and written communication skills.
  
• Public speaking and presentation expertise.
  
• Proven relationship-building skills.
  
• Ability to manage partner vendor relationships (e.g., wellness, IT, clinical).
  
• Strong collaboration with internal stakeholders, including government affairs, service, legal, and foundation teams.
  

Travel:

• Travel throughout the United States is required. Majority of travel will be throughout the state of NJ but there will be times where out of state travel is required.
  

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:
$125,100 - $151,095

This position is eligible for sales incentive compensation in addition to base pay. 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.