Care Transformation Coach

Overview Horizon Blue Cross Blue Shield of New Jersey is seeking a Care Transformation Coach to work directly with providers of care to implement and sustain innovative, value‑based programs within the New Jersey healthcare delivery system. The role supports Horizons Value‑Based programs, provides exceptional service, and helps contain medical claims costs. Responsibilities Perform data interpretation and analysis, performance reviews and readiness assessments to determine strategies, workflows, and tactics that result in care transformation to meet performance indicators and achieve the triple aim. Design high‑quality action and/or project plans to drive value‑based initiatives, including developing projects that support strategic partners with identification of needs, implementation, monitoring, and refinement. Strategically focus with stakeholders to assist with identifying and prioritizing goals to enhance care delivery, reduce cost, and improve quality. Chair or participate in specific internal and external core teams and/or work streams, offering background expertise to support transformation efforts for strategic partners. Lead creation and facilitation of individualized, customized Value‑Based trainings, including in‑services and webinars, and provide train‑the‑trainer sessions to expand transformation activities. Create and facilitate the appropriate use of educational materials, considering health literacy for internal and external partners (e.g., Value‑Based programs, motivational interviewing) to drive learning collaboration and healthcare delivery transformation focused on population health. Develop and implement customized tools to support performance improvement. Examine and convey data, project findings, results, and action plans to internal and external stakeholders. Utilize best practices to collaborate and optimize continuous improvement processes among Value‑Based partners. Work collaboratively with internal and external stakeholders to identify cultural change needs that support synergy among value‑based programs. Develop and communicate key performance indicators to monitor adherence to best practices and achievement of member outcomes. Maintain superior relationships with strategic partners, including health care providers, facilities, and other health care stakeholders throughout New Jersey. Champion a collaborative cross‑departmental and cross‑team environment and communication between transformation teams and other Horizon departments (health affairs, network management, sales, analytics, and government programs). Utilize clinical best practices, based on research, national pilots, and Horizon experience, for internal teams and external customers. Qualifications & Experience High School Diploma or GED required. Bachelor’s degree in Healthcare Management or related field preferred; relevant experience may substitute for a degree. Minimum five (5) years of clinical experience in a health plan, hospital, or physician practice setting. Preferred credentials: RN, licensed clinical social worker, or Master of Public Health. Direct experience with disease management, preventative management, or population health programs. Direct experience using data analysis to drive population health management and process improvement. Experience in continuous quality improvement/quality management/rapid cycle improvement. Direct experience with behavioral coaching or motivational interviewing preferred. Preferred project management experience. Additional licensing, certifications, or registrations: Licensed RN or SW preferred. Active New Jersey driver’s license required. Knowledge Basic knowledge of health plan activities including utilization management, CCM, disease management/population‑based case management, basic claims processing, contracting, and enrollment. Knowledge of health care systems, practice‑based and hospital‑based care delivery, fundamentals of population health, value‑based payment models, and medical documentation. Skills Proven ability to influence without authority and achieve results through others in a decentralized organization. Strong facilitator skills, leading cross‑functional teams to achieve improvements and solve challenging problems. Effective, professional verbal and written communication. Strong public speaking and presentation skills. Excellent interpersonal skills and ability to work with all levels. Project management skills. Proficiency in Windows‑based software, including MS Office (Word, Excel, Outlook, PowerPoint). Strong organizational ability and priority setting. Innovative, critical thinker and problem solver. Flexible, adaptable to change, and able to work independently or in a team. Sound judgment and initiative in finding solutions to difficult situations. Travel Significant travel within the state of New Jersey. Compensation and Benefits Salary Range: $87,300 – $119,070. Benefits include comprehensive health benefits (Medical, Dental, Vision), retirement plans, generous PTO, incentive plans, wellness programs, paid volunteer time, and tuition reimbursement. Equal Opportunity Employer 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 disability status, 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. #J-18808-Ljbffr 100 Horizon Healthcare Services, Inc