Provider Performance & Network Manager

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

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