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Job Summary
This position is responsible for supporting the development, performance management, and oversight of their assigned provider networks in the Northeast (New Jersey, Pennsylvania, Delaware) market territory. The Senior Network Management Consultant will work to build and maintain strong relationships with their assigned provider networks to help impact key performance metrics that benefit the members we serve.
Key Responsibilities:
*Establish and maintain key relationships within assigned territory for small to mid-size physicians, physician groups and facilities (e.g. independent hospitals, independent physicians with negotiations, small group / IPAs, etc.). May assist with complex or large groups.
*Conducting regular provider visits to educate providers and office staff on topics including, but not limited to: preventative and quality outcome metrics, risk adjustment, medical cost management, etc. Work with internal departments to ensure appropriate implementation of executed agreements.
*Educating providers on the performance requirements associated with value-based contracts.
*Understanding, developing, tracking, monitoring and reporting on key program performance metrics, such as utilization, coding, and Stars/quality performance. Communicate and interact effectively and professionally with co-workers, management, customers, etc.
Required Job Qualifications:
*Bachelor’s degree and 3 years’ experience OR 7 years managed care operations experience including provider relations.
*Knowledge of provider and facility contracting, products, and claims/processing systems.
*Meet deadlines and work well under pressure.
*Relationship building skills.
*Verbal and written communication skills; organizational and planning skills.
*PC proficiency to include Microsoft Office.
*Analytical skills.
*Ability and willingness to travel within assigned areas of responsibility, including overnight stays
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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
$61,500.00 - $136,100.00
Exact compensation may vary based on skills, experience, and location.