Provider Network & Performance Manager

Health Care Service Corp.; Houston (TX); Hybrid; USD 93,000 - 168,000; Full time

Job summary

Health Care Service Corporation (HCSC) is seeking a senior leader to manage provider performance and contracting strategies across physicians, physician groups, and facilities in a value-based care environment. You will lead a team, negotiate contracts, enhance HEDIS/STARS outcomes, and drive financial performance while building strong provider relationships.

This role requires deep knowledge of provider contracting, a consultative, data-driven approach, and the ability to travel within the

Qualifications

• Bachelor Degree and 5 years provider contracting experience OR 9 years managed care experience including 5 years provider contracting.
• 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.

Responsibilities

• Lead and mentor a team of Provider Performance Network Operations Consultants.
• Develop and negotiate contracts for physicians, physician groups, and facilities, including large health systems.
• Improve provider HEDIS, STARS, risk adjustment, and financial performance through data-driven strategies.

Skills

Leadership skills

Negotiation skills

Relationship building

Analytical skills

Project management

Travel willingness

Education

Bachelor Degree in relevant field

9 years managed care experience including 5 years provider contracting

Tools

Microsoft Office

Job description

Health Care Service Corporation (HCSC) is seeking a senior leader to manage provider performance and contracting strategies across physicians, physician groups, and facilities in a value-based care environment. You will lead a team, negotiate contracts, enhance HEDIS/STARS outcomes, and drive financial performance while building strong provider relationships.

This role requires deep knowledge of provider contracting, a consultative, data-driven approach, and the ability to travel within the