Network Management Consultant

Health Care Service Corporation•Chicago, IL

5d•Hybrid

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 OH market territory. The 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. Ability and willingness to travel within assigned territory, including overnight stays as needed.

Requirements

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

Nice To Haves

Bachelor Degree in Business.

Responsibilities

Establishing and managing strong, solid relationships with assigned provider groups and their staff (e.g. physicians, practice managers, care coordination teams), as well as executing with provider group on initiatives that benefit the customer, provider, and health plan
Educating providers on the performance requirements associated with value-based contracts.
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.
Understanding, developing, tracking, monitoring and reporting on key program performance metrics, such as utilization, coding, and Stars/quality performance.