Self-Direction PPP Support Counselor (Field Based - Somerset County)

About the Role

The Self-Direction PPP Support Counselor is responsible for conducting quarterly in-person evaluations on members enrolled in the Personal Preference Program. During these quarterly meetings, the Support Counselor handles all workforce functions including budgeting, back-up plan, capacity planning, forecasting, safety planning, scheduling, and real-time monitoring. The Support Counselor provides member assistance and strategic insight during the development and review of the member’s cash management plan, budget performance, review of monthly results, and ensures the cash management plan meets the member’s needs.

Responsibilities

• Work with members 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 their monthly budget allowance.
• Review and update the monthly budget on a quarterly basis, as needed.
• Develop and review the 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 the 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 visit notes must be completed during the visit and uploaded on the day of the participant’s 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.

Requirements

• High School Diploma/GED required.
• LPN or healthcare background preferred.
• Equivalent and relevant professional experience in budgeting or finance preferred but not required.
• Minimum of 3 years’ experience in the health insurance industry or a professional business-related field required.
• Experience with MS Office and other WFM solutions highly preferred.

Skills and Qualifications

• Knowledge of the healthcare industry is helpful.
• Ability to balance multiple priorities.
• Team player with strong analytical and interpersonal skills.
• Proficient in MS Word, MS Excel, and MS PowerPoint.
• Demonstrated strong analytical skills with an emphasis on forecasting.
• Ability and willingness to learn new software applications.
• Skills in problem-solving, judgment, critical thinking, and decision-making.
• Highly organized with an emphasis on accuracy and timeliness.
• Ability to organize information, follow procedures accurately, and pay attention to detail.
• Ability to work alone with minimum supervision and with others in a team environment, occasionally under time pressure and on several tasks simultaneously.
• 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.

Benefits

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

Pay

Salary Range: $63,000 - $84,420. This compensation range is specific to the job level and takes into account factors such as education, experience, licensure, certifications, geographic location, and internal equity.

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