Network Outreach Specialist

Horizon Connect @ Wall BCBSNJ

. Gather attestation and validation on the accuracy of provider network data as displayed in local directories.

Posted 10/27/2026full-timeRemote • United StatesMid-LevelSenior💰 $50,100 - $67,095 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in provider network data management, customer service, and compliance with healthcare regulations. Proficient in communication and problem resolution within a managed care environment.

Highest-signal resume keywords

Customer Service ExperienceHealthcare Industry KnowledgeProvider Network ManagementMS Office ProficiencyCommunication Skills

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Data ValidationProvider SurveysEligibility VerificationCredentialing AssistanceProblem Resolution

Soft Skills

Interpersonal SkillsOrganizational SkillsOral CommunicationWritten Communication

Tools & Technologies

Windows EnvironmentMS Office ProductsLotus NotesIntranet ApplicationsInternet Applications

Industry Keywords

Managed CareHealth InsuranceDOBI ComplianceCMS RegulationsNCQA Standards

About the role

Key responsibilities & impact

Gather attestation and validation on the accuracy of provider network data as displayed in local directories.
Make outbound validation calls to providers regarding demographic practitioner details for each practice location across Horizon networks.
Contact members regarding preventive health activities.
Receive inbound service calls and provide accurate, complete information in response to provider inquiries, complaints and problems.
Contact provider offices to encourage ongoing education and dialogue on data management best practices and attend scheduled orientation and educational outreach activities.
Conduct provider surveys and assessments as applicable.
Act as liaison with providers, members and outside community resources.
Handle PCP/PCD changes for members.
Verify PCP/PCD and member eligibility with providers.
Maintain call documentation in databases for special outreach projects.
Assist provider offices with credentialing, recredentialing, claims and provider data maintenance issues by providing process guidance.
Ensure compliance with DOBI, CMS and NCQA accuracy regulations.

Requirements

What you’ll need

High School Diploma/GED required.
Requires a minimum of 3 years of experience in customer service, telephone sales preferably in a Managed Care environment.
Some experience with provider practices, physicians and/or office managers in a healthcare, group practice setting.
Prefers knowledge of Horizon products and services.
Requires knowledge of health insurance industry.
Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes.
Should be knowledgeable in the use of intranet and internet applications.
Requires excellent oral and written communication skills.
Requires strong interpersonal and organization skills.
Requires ability to resolve problems.
Employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware.

Benefits

Comp & perks

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