Sr Network Mgmt Consultant

Health Care Service Corporation • Chicago, IL

2d

About The Position

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 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.

Requirements

• 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

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.

Benefits

• 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.
• This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level