Senior Manager Prof Provider Network Performance - Work From Home

Health Care Service Corporation; Birmingham (AL); Hybrid; USD 93,000 - 168,000; Full time

Job summary

HealthCare Service Corporation (HCSC) seeks a Senior Manager to lead provider network performance and growth for the HealthSpring Medicare Advantage business. You will supervise providers and internal teams, negotiate agreements, and drive quality, affordability, and member satisfaction.

The role emphasizes collaboration across functions, cross‑functional leadership, and ensuring CMS compliance. Based in the Alabama/Southern region, travel is required and onsite work at provider offices is

Qualifications

• Bachelor’s Degree in Business or related field plus four years of health care administration or managed care experience.
• Demonstrated verbal and written communication skills with all levels of personnel and providers.
• Demonstrated analytical abilities and proficient planning skills.
• Effective negotiation skills.
• Ability to meet deadlines and work under pressure.
• Willingness to travel, including overnight stays.

Responsibilities

• Oversee provider network performance, quality, affordability, and member satisfaction.
• Lead Provider Performance teams and supervise staff through training and coaching.
• Negotiate provider agreements and collaborate with internal stakeholders to improve outcomes.
• Ensure CMS and company policy compliance and support Stars and Risk Adjustment goals.

Skills

Verbal & written comms

Negotiation

Analytical abilities

Planning

Deadline orientation

Travel willingness

Education

Bachelor’s Degree in Business or related field

MBA or Master’s degree (preferred)

Tools

Excel

Job description

At 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 the development and maintenance of harmonious working relationships with assigned providers, negotiating provider agreements, assigning responsibilities to team members, and leading staff through training, coaching, performance management, and other supervisory responsibilities. As a key member of a cross-functional organization, the Senior Manager oversees the performance and growth of an assigned provider network, partnering with providers and internal stakeholders to drive quality, affordability, operational excellence, and member satisfaction. This role provides leadership for Provider Performance teams, oversees provider network financial performance and value-based initiatives, supports Stars and Risk Adjustment goals, ensures compliance with CMS and company policies, and collaborates across the organization to strengthen provider relationships, improve health outcomes, and support the continued growth and profitability of the HealthSpring Medicare Advantage business.

Required Job requirements

• Bachelor’s Degree in Business or related field plus four years of health care administration or managed care experience. Eight years of similar experience may substitute.

• Effective verbal and written communication skills to interact with all levels of corporate personnel and assigned providers.

• Demonstrated analytical abilities and proficient planning skills.

• Effective negotiation skills.

• Demonstrated ability to meet deadlines and work well under pressure.

• Team player/people oriented.

• Ability and willingness to travel, including overnight stays.

• Individuals must live within 380 miles from the territory serviced.

Preferred Job 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.

• Master’s degree, MBA or other

Additional Details:

• Territory: Alabama, Southern Mississippi, Florida Pan Handle

• Client-site Location: This is a field based position. 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

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 plansubject 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

Exact compensation may vary based on skills, experience, and location.