Provider Performance Network Consultant (HEDIS/STARS)

HCSC Group; Houston (TX); Hybrid; USD 56,000 - 124,000; Full time

Job summary

Health Care Service Corporation (HCSC) seeks a Network Management Consultant in the Houston area to drive provider performance, negotiate contracts, and manage payer relationships. The role includes travel within the Houston market, educating providers and coordinating with hospital networks to improve HEDIS and STARs metrics.

The ideal candidate has a Bachelor's degree with related contract experience or strong managed care operations background, plus excellent analytical and communication

Qualifications

• Bachelor's degree and 1 year of provider contract experience or 5 years in managed care operations.
• Strong written and verbal communication, organizational and planning skills.
• Analytical thinker with ability to meet deadlines and work under pressure.

Responsibilities

• Support HEDIS, STARS and provider performance initiatives in toptical coverage.
• Negotiate and develop provider contracts with physicians and groups.
• Build and maintain provider relationships and deliver education and service.
• Travel within the territory, including overnight stays, as needed.

Skills

Contract negotiations

Provider contracts

Data analysis

Travel readiness

Communication skills

Project management

Education

Bachelor Degree

Tools

Microsoft Office

Job description

Health Care Service Corporation (HCSC) seeks a Network Management Consultant in the Houston area to drive provider performance, negotiate contracts, and manage payer relationships. The role includes travel within the Houston market, educating providers and coordinating with hospital networks to improve HEDIS and STARs metrics.

The ideal candidate has a Bachelor's degree with related contract experience or strong managed care operations background, plus excellent analytical and communication