Quality Outreach Specialist

Overview

United States, New Jersey, Parsippany-Troy Hills

Jan 26, 2026

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.

This position is responsible for the coordination, implementation, and monitoring of all Commercial (Stars) HEDIS member and provider outreach, engagement, and intervention. This position is also responsible for assisting Manager, Outreach & Interventions to operationalize all initiatives to improve our HEDIS performance by working with internal and external stakeholders.

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.

• Collaborate in designing, implementing, and monitoring all outreach and intervention progress with management.
• Build and maintain relationships with Member Experience, PC&S, Govt. Program Communications, Enterprise Communications, Analytics, and external vendors to assist in implementing all initiatives to improve HEDIS performance.
• Support manager in monitoring initiatives and performance for all vendors and ensure initiatives are within budget and aligned with expectations to improve performance.
• Collect, analyze, and synthesize data for the development of materials to guide departments in decision making for Medicare and Medicaid populations' health management, cost of health care management, and quality of care.
• Compile comprehensive monthly, quarterly, and annual reports to summarize the efficacy and impact of all interventions to support strategic improvement of HEDIS performance, including related provider outreach, engagement, and intervention activities.
• Participate in outreach activities for the program as appropriate and develop outreach and in-reach materials to promote services.
• Facilitate and participate in meetings and presentations with internal and external audiences. Perform other related duties as assigned or directed.

• High School Diploma/GED required.
• Requires a minimum of 3 years of experience in Population Health Management or 3 years of experience with social determinants of health for behavioral health.
• Experience and understanding of NCQA, HEDIS, or URAQ standards.
• Requires 3–5 years of managed care experience.

• Knowledge of health care delivery systems, distribution channels, health care industry and health insurance industry.
• Knowledge of applicable laws and regulations as well as Governmental Agencies and Regulatory.
• Knowledge of HEDIS, CAHPS, and Stars for CMS.
• Knowledge of quality improvement methodology.
• Knowledge of PCs and applicable software applications.

• Excellent written and oral communication skills.
• Aptitude for analytical thinking and ability to report findings accurately.
• Strong interpersonal, organizational and problem-solving skills.
• Strong project management skills.
• Strong relationship-building skills to work collaboratively across departments/divisions.
• Proficient in Windows-based PC software, including MS Office (Word, Excel, PowerPoint); familiarity with intranet and internet applications.
• Prefer knowledge of user-oriented programming languages including SAS, SQL.

• Some travel required

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware.

$70,500 - $94,395

This compensation range is specific to the job level and considers factors such as education, experience, licensure, certifications, geographic location, and internal equity. It is provided in good faith based on information known izon offers a comprehensive compensation and benefits package including:

• Comprehensive health benefits (Medical/Dental/Vision)
• Retirement Plans
• Generous PTO
• Incentive Plans
• Wellness Programs
• Paid Volunteer Time Off
• Tuition Reimbursement

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.

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for…