Self-Direction PPP Support Counselor Lead (Southern NJ Counties)

About the role

The Self Direction Personal Preference Program (PPP) Support Counselor Lead provides advanced program expertise while continuing to perform core PPP Support Counselor functions. This role mentors, trains, and precepts new and existing staff, serving as a subject matter expert across all PPP workflows, including initial and quarterly in-person member visits. The Lead supports operational functions such as budgeting, scheduling, forecasting, capacity monitoring, and safety, and provides strategic guidance on cash management plans. Additionally, the role consults complex cases, supports quality assurance efforts, and promotes regulatory compliance, consistency, and continuous improvement across the program.

Responsibilities

• Perform PPP Support Counselor duties in accordance with established guidelines while supporting the preparation of new and existing counselors for independent work through training, mentoring, and hands-on guidance.
• Serve as a PPP subject matter expert, offering technical assistance, knowledge-sharing, and remediation support to peers as needed.
• Provide expertise on organizational and Fiscal Intermediary (FI) vendor medical management systems.
• Act as a regional triage resource for PPP-related complaints, grievances, and appeals, ensuring appropriate routing, documentation, and follow-up in alignment with policy.
• Travel within the state as needed to support training initiatives, staff development, and case coverage.
• Adhere to and support protocols related to PPP Support Counselor retraining and continuous quality improvement.
• Prepare and present mentee progress updates to leadership, highlighting outcomes, skill development, and opportunities for further improvement.
• Complete special projects and other duties as assigned by management to support program operations and quality outcomes.

Requirements

• A high school diploma/GED is required.
• An LPN or healthcare background is preferred.
• Equivalent and relevant professional experience in budgeting or finance is preferred.
• A minimum of 5 years’ experience in the health insurance industry or professional business-related field is required.
• A minimum of 3 years’ experience with financial counseling for the Personal Preference program is required.
• Experience with MS Office and other WFM solutions is highly preferred.

Qualifications

• Strong analytical skills with emphasis on forecasting.
• Effective communication and presentation skills, as needed in a lead/trainer position.
• The ability to work independently and resolve problems through interaction with multiple departments and personnel.
• A strong knowledge of the PPP Support Counselor role and ability to be highly organized with an emphasis on accuracy and timeliness.

Skills & Abilities

• Demonstrate strong analytical skills with emphasis on forecasting.
• Effective communication and presentation skills, as needed in a lead/trainer position.
• The ability to work independently and resolve problems through interaction with multiple departments and personnel.
• A strong knowledge of the PPP Support Counselor role and ability to be highly organized with an emphasis on accuracy and timeliness.

Pay

Salary Range: $79,100 - $105,945. 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.

Benefits

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

Disclaimer

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.