Senior Manager Prof Provider Network Performance - Work From Home

HCSC Group; Birmingham, Northern (AL, KY); Hybrid; USD 93,000 - 168,000; Full time

Job summary

Health Care Service Corporation (HCSC) seeks a Senior Manager to lead provider network development and performance, negotiate agreements, and coach a cross-functional team. You will align provider and internal stakeholders to improve quality, affordability, and member satisfaction within the Medicare Advantage space.

Role requires a Bachelor's degree in business or related field with health care administration experience, strong communication and analytical skills, and willingness to travel

Qualifications

• Bachelor’s Degree in Business or related field with 4 years healthcare admin experience (8 years may substitute).
• Strong verbal and written communication; interact with all levels.
• Analytical abilities and proficient planning; strong negotiation skills.
• Willingness to travel; territory includes Alabama/Southern US within 380 miles.

Responsibilities

• Manage development and maintenance of relationships with assigned providers and negotiate provider agreements.
• Lead staff through training, coaching, and performance management.
• Oversee provider network performance, drive quality, affordability, and member satisfaction.
• Support CMS STARs and risk adjustment goals and ensure compliance with policies.

Skills

Verbal & written communication

Analytical skills

Negotiation skills

Planning skills

Team player

Travel willingness

Education

Bachelor's Degree in Business or related field

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

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

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

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 plan subject to the terms and the conditions of the plan.

HCSC Employment Statement

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.

For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans.

Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace.