Provider Management Consultant

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

This role is responsible for supporting development and growth of positive, long-term relationships with physicians, providers, multi specialty clinics, and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Provider Vertical Leader works to identify the business plan and will have growth objectives. They will navigate the C Suite and execution of strategies in conjunction with the HCSC Contracting teams. assignments involves complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

REQUIRED QUALIFICATIONS:

• Bachelor's Degree with 5-7 years experience in a Healthcare or Managed Care environment, including 3 or more years of hands-on experience in Provider Contracting, Network Management, or Provider Relations
• Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies
• Demonstrated ability to manage multiple projects and meet deadlines
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance
• Detail oriented professional with excellent written and verbal communication skills
• CMS regulatory requirements, including Medicare Marketing Guidelines
• Experience with Medicare products (including Medicare Advantage, Medicare Prescription Drug Plan (PDP) and Medicare Supplement products)

This is a Flex (Hybrid) role: 3 days in office; 2 days remote.

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees.  Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range

$60,300.00 - $133,400.00

Exact compensation may vary based on skills, experience, and location.