Health Care Service Corporation

Network Management Consultant - Work From Home

Health Care Service Corporation$55K — $123K *
US-AnywhereRemote in Nashville, TN
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Degree and 1 year of contract negotiation experience, or 5 years in managed care operations with 1 year in contract negotiation.
  • Strong ability to meet deadlines and thrive under pressure.
  • Effective verbal and written communication skills, alongside strong organizational abilities.
  • PC proficient, particularly in Microsoft Office tools.
  • Solid analytical skills focused on gap analysis and remediation planning.
  • Willingness to travel within territory, with occasional overnight stays.

Responsibilities

  • Support Provider Recruitment and Contracting processes to ensure network adequacy in assigned territory.
  • Conduct analysis and targeted reporting on network gaps.
  • Develop remediation plans to address identified network issues.
  • Assist in complex hospital and physician contracting activities.
  • Collaborate with internal teams during meetings, requiring travel as needed.

Benefits

  • Health and wellness benefits including comprehensive medical coverage.
  • 401(k) savings plan with company contributions.
  • Pension plan to support retirement savings.
  • Paid time off and parental leave for work-life balance.
  • Disability and supplemental life insurance for added security.
  • Paid holidays and tuition reimbursement for professional development.
  • Employee assistance programs to support personal and family needs.
Full Job Description
Job Summary

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%).

Required Job Qualifications:
  • 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


Preferred Job Qualifications:
  • 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


Sponsorship will not be provided for this role.

This is a Telecommute (Remote) role.

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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
$55,900.00 - $123,500.00

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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