Manager, Network Management - Provider Performance - Houston, TX

HCSC Group; Houston (TX); Hybrid; USD 93,000 - 168,000; Full time

Job summary

Health Care Service Corporation (HCSC) in Houston seeks a Manager, Network Management - Provider Performance to lead daily operations, improve provider performance metrics including HEDIS and STARs, and drive strategic contracting for physicians, groups, and facilities. You will recruit, contract, and educate providers while guiding a team of Network Operations Consultants.

You will mentor staff, serve as a subject-matter expert, and steer data-driven initiatives to achieve client goals in

Qualifications

• Bachelor degree required or equivalent experience in managed care.
• Experience in provider contracting and negotiation is essential.
• Ability to lead and develop teams in a matrix organization.
• Strong analytical and project-management capabilities.

Responsibilities

• Lead daily operations and strategies to improve provider HEDIS, STARS, risk adjustment, and financial performance.
• Oversee provider recruitment, contracting, and relationship management for physicians, groups, and facilities.
• Manage and mentor Network Operations Consultants and act as SME to improve efficiency and results.
• Develop actionable plans, measure outcomes, and adjust strategies to meet client goals in value-based care.

Skills

Provider contracting

Leadership

Negotiation

Relationship building

Analytical skills

Project management

Communication

Travel willingness

Education

Bachelor's degree

Tools

Microsoft Excel

Job description

## Manager, Network Management - Provider Performance - Houston, TXApply: Remote: TX - Houston: Full time: Posted Today: R0055840At 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 managing daily activities and implementing strategies to improve provider HEDIS, STARS, risk adjustment, and financial performance while leading provider recruitment and contracting efforts for physicians, physician groups, and facilities, including large or complex health systems and value-based arrangements. The role develops and negotiates contracts, builds and maintains strong provider relationships, ensures strategic coverage within the assigned territory, and provides ongoing provider education and service. Leading a team of Provider Performance Network Operations Consultants, this individual is responsible for the management, mentoring, and training of provider support resources while serving as a subject matter expert to improve efficiencies and results. Success in this role requires a consultative, data-driven leader who can engage physicians, influence behavior change, identify performance improvement opportunities, develop actionable plans, measure outcomes, and adjust strategies to achieve client goals in a value-based care environment### **JOB REQUIREMENTS:*** Bachelor Degree and 5 years provider contracting experience OR 9 years managed care experience including 5 years provider contracting experience.* Extensive knowledge of provider and facility contracting, products, and claims/processing systems.* Leadership skills to oversee staff, implement initiatives, and work across the company to resolve issues.* Negotiation skills.* Relationship building skills.* Knowledge of marketplace.* Meet deadlines and work well under pressure.* Verbal and written communication skills to interact with all levels of corporate personnel and providers.* PC proficiency to include Microsoft Office.* Analytical skills* Project management skills to lead or participate in projects or initiatives.* Ability and willingness to travel within assigned areas of responsibility, including overnight stays **PREFERRED REQUIREMENTS:*** **Previous HEDIS and/or CMS STARs experience*** Solid understanding of health insurance, customer messaging/design and project management* Expert level of Excel preferred (knowledge of pivot tables, VLOOKUP, etc.).* Experience in financial/trend analysis* Team player with proven ability to foster and manage working relationships within a matrix environment to obtain buy-in and drive results. **ADDITIONAL DETAILS:*** **Client-site Location:** This is a field based position in the Houston market. The individual will be onsite at provider offices typically 3 days a week and work from home 2 days a week.* **Schedule:** Monday - Friday, typical business hours with infrequent evening and weekend meetings.* **Sponsorship:** Sponsorship is not available### **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.## HCSC Employment Statement:We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.# # **Base Pay Range**$92,700.00 - $167,500.00