Provider Relations Specialist — Data & Partnerships

hcsc; Springfield (IL); Hybrid; USD 70,000 - 100,000; Full time

Job summary

HCSC is seeking a Provider Relations role to manage contracting, credentialing, and ongoing data maintenance for a broad provider network. The position emphasizes building strong provider relations, data quality, and cross-department collaboration across all lines of business in a hybrid work setting.

The role requires a Bachelor's degree and 3+ years in managed care (5+ years acceptable), with travel for provider engagement and training responsibilities. Relocation is not offered.

Qualifications

• Bachelor's Degree or equivalent managed care experience.
• 3+ years in managed care; 5+ years acceptable.
• Excellent communication, presentation, and problem-solving skills.

Responsibilities

• Establishes and maintains relationships with Blue Cross contracted providers.
• Escalate provider issues and coordinate claims resolution.
• Maintain knowledge of provider contracts across all lines of business.
• Lead internal/external seminars and prepare PowerPoint decks.
• Train and educate contracted providers on processes and systems.
• Collaborate across departments to improve provider relations.

Skills

Interpersonal skills

Analytical skills

Presentation skills

Communication skills

Healthcare industry knowledge

Ability to travel

Contracts knowledge

Claims knowledge

Organizational skills

PC proficiency

Education

Bachelor's Degree (related field)

IAMHP affiliation

Tools

Excel

PowerPoint

Salesforce

Provider management systems

Job description

HCSC is seeking a Provider Relations role to manage contracting, credentialing, and ongoing data maintenance for a broad provider network. The position emphasizes building strong provider relations, data quality, and cross-department collaboration across all lines of business in a hybrid work setting.

The role requires a Bachelor's degree and 3+ years in managed care (5+ years acceptable), with travel for provider engagement and training responsibilities. Relocation is not offered.