Health Care Service Corporation

Director of Provider Contracting

Health Care Service Corporation$121K — $225K *
US-AnywhereRemote in Albuquerque, NM
Healthcare
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Degree with 10 years of healthcare or health insurance experience including 4 years in contract administration and provider relations.
  • 14 years of healthcare or health insurance experience with 4 years in contract administration and provider relations, as an alternative qualification.
  • 4 years of management experience covering hiring, performance management, change management, and professional development.
  • Expertise in reimbursement methodology and financial acumen with budget oversight experience.
  • Strong knowledge of facility/provider contracting methodologies and pricing strategies.

Responsibilities

  • Oversee the annual budget and allocate resources for various projects and operational needs.
  • Translate needs and initiatives into compelling business cases for the organization.
  • Conduct cost-benefit analyses to justify investments and ensure Return on Investment (ROI).
  • Develop and implement competitive contract pricing methodologies.
  • Manage a wide network of hospitals and providers while fostering strong provider relations.

Benefits

  • Health and wellness benefits.
  • 401(k) savings plan and pension plan.
  • Paid time off and paid parental leave.
  • Disability insurance and supplemental life insurance.
  • Employee assistance program and paid holidays.
  • Tuition reimbursement and additional incentives.
Full Job Description
Job Summary

This position is responsible for developing and implementing the methodology which results in competitive contract pricing while maintaining a broad network of hospitals, physicians, behavioral health and ancillary providers on a statewide basis. Directing and overseeing management and staff responsible for contracting, provider relations activities, network directories, provider/facility database and reporting. This position collaborates with HCSC Network Management colleagues in the development of Enterprise Network strategies and initiatives.

JOB REQUIREMENTS:

* Bachelor Degree and 10 years health care or health insurance experience to include 4 years contract administration and facility or provider relations experience OR 14 years of health care or health insurance experience to include 4 years contract administration and facility or provider relations experience.
* 4 years management experience including hiring, performance management, change management and professional development.

* Reimbursement Methodology expertise
* Leadership skills.
* Financial acumen, experience with oversight of budget, and experience with financial managed care contracting.
* Knowledge of facility/provider contracting methodologies and pricing strategies and the facility or provider community.
* Presentation skills.
* Negotiation, contracting skills and analytical and strategic thinking skills.
* Verbal and written communication skills.

* Overseeing the annual budget and allocating resources for various projects and operational needs.

* Translating needs and initiatives into compelling business cases.

* Conducting cost-benefit analyses to justify investments and ensure ROI.

PREFERRED JOB REQUIREMENTS:
* Masters Degree.
* Experience developing strategies and implementing initiatives.
* Experience developing budget.

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.

Base Pay Range
$121,200.00 - $225,200.00

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

About Health Care Service Corporation

Health Care Service Corporation (HCSC) is the largest customer-owned health insurer in the United States. HCSC offers a wide variety of health insurance products and related services, through its operating divisions and subsidiaries in Illinois, Montana, New Mexico, Oklahoma and Texas. HCSC's headquarters is located in Chicago, Illinois.
Learn more about Health Care Service Corporation
Size
24,000 employees
Industry
Founded
1936

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