Health Care Service Corporation

Sr Network Management Consultant (Behavioral Health) - Work From Home

Health Care Service Corporation$61K — $136K *
US-AnywhereRemote in Richardson, TX
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Degree and 3 years of provider contracting experience, or 7 years of business experience including 3 years of provider contracting experience.
  • Knowledge of provider and facility contracting and claims processing systems.
  • Strong negotiation skills essential for contract development.
  • Ability to build and maintain relationships with healthcare providers.
  • In-depth understanding of the marketplace dynamics in behavioral health.
  • Capable of meeting deadlines and thriving under pressure.
  • Excellent verbal and written communication, organizational, and planning skills.

Responsibilities

  • Develop and negotiate contracts with small to mid-size behavioral health providers and facilities.
  • Build and maintain relationships with key healthcare providers in assigned territory.
  • Educate behavioral health providers on services and ensure high levels of ongoing service.
  • Adjust contracts and make necessary changes to fee schedules and contract language.
  • Support contracting with larger behavioral health groups or facilities as needed.
  • Strategically cover and expand the network presence in Illinois and national markets.
  • Travel within assigned areas for contract negotiations and provider engagement.

Benefits

  • Comprehensive health and wellness benefits.
  • 401(k) savings plan and pension plan for retirement.
  • Paid time off, including parental leave and holidays.
  • Disability insurance and supplemental life insurance offerings.
  • Employee assistance program for mental health support.
  • Tuition reimbursement for ongoing education.
Full Job Description
Job Summary

SUMMARY:
This position is responsible for small to mid-size behavioral health provider and facilities recruitment and contracting activities (independent hospitals, independent physicians with negotiations, etc). Develop and negotiate contracts. Develop and maintain relationships with providers. Ensure strategic coverage for assigned territory. Responsible for education of behavioral health providers and for ongoing provider service. May be responsible for or assist with contracting or supporting services large or complex behavioral health groups/facilities. Ability and willingness to travel within assigned areas of responsibility, including overnight stays (as needed, rare). This role will oversee adjustment regarding contracts, red-line changes, fee schedules, contract language changes, etc. for Illinois and expanding national markets/presence.

JOB REQUIREMENTS:
  • Bachelor Degree and 3 years provider contracting experience OR 7 years business experience including 3 years provider contracting experience.
  • Knowledge of provider and facility contracting, products, and claims/processing systems.
  • Negotiation skills.
  • Relationship building skills.
  • Knowledge of marketplace.
  • 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 areas of responsibility, including overnight stays


Preferred Requirements:
  • At least 2 years of Behavioral Health knowledge and experience, including: contracting (issuing and defending agreements), rate negotiation, modeling and market analysis.
  • Experience with regulatory deliverables for state and federal filings.
  • Exceptional written and verbal communication skills, with polished email and phone etiquette and the ability to confidently interact with senior leaders and executives.
  • Previous expert level experience with high-volume Microsoft Office, Excel (V-Look Ups, Pivot Tables), PowerPoint, etc.


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
$61,500.00 - $136,100.00

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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