Note: The job is a remote job and is open to candidates in USA. Health Care Service Corporation is a purpose-driven healthcare organization that invests in employee development. The Network Management Consultant supports provider recruitment and contracting by analyzing network adequacy, reporting gaps, planning remediation, and assisting with complex hospital and physician contracting activities.
Responsibilities
- This position is responsible for providing support to the Provider Recruitment and Contracting process to ensure network adequacy guidance in assigned territory
- Specific responsibilities include analysis, targeted gap reporting, and remediation planning in support of network management operations
- This role will also provide support for complex hospital and physician contracting activities
- Ability and willingness to travel to offices for internal meetings as needed, including overnight stays (less than 3%)
Skills
- Bachelor Degree and at least one year experience developing and negotiating provider contracts OR 5 years managed care operations experience handling independent work with at least one year experience developing and negotiating provider contracts
- Meet deadlines and work well under pressure
- Verbal and written communication skills, organizational and planning skills
- PC proficiency to include Microsoft Office
- Analytical skills
- Ability and willingness to travel within assigned territory, including overnight stays
- Bachelor Degree in Business, Finance, Economics - **HIGHLY PREFERRED**
- Experience working with Medicare Advantage and CMS regulations **- HIGHLY PREFERRED**
- Strong understanding of healthcare network adequacy requirements
- Demonstrated ability to investigate and resolve network gaps
- Proven track record of monitoring project milestones, negotiation activities and implementation progress
- Excellent communication and stakeholder management skills
Benefits
- 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
- Annual incentive bonus plan
- Curated development plans that foster growth and promote rewarding, fulfilling careers
- Telecommute (Remote) role
Company Overview