Senior Manager Prof Provider Network Performance - Work From Home

HCSC; Huntsville (AL); Hybrid; USD 93,000 - 168,000; Full time

Job summary

Health Care Service Corporation (HCSC) is seeking a Senior Manager to oversee provider performance, negotiate agreements, and lead a cross-functional team. You will drive quality, affordability, and member satisfaction across a field-based territory in the southern US.

The role requires a Bachelor's degree in Business or related field with healthcare experience, strong communication, and analytical skills. Travel is expected; onsite 3 days a week with some remote work as needed.

Qualifications

• Bachelor's degree in Business or related field plus four years of health care administration or managed care.
• Strong verbal and written communication with diverse stakeholders.
• Demonstrated analytical abilities and planning skills.
• Solid negotiation skills.
• Ability to meet deadlines and work under pressure.
• Team player with people orientation.
• Willingness to travel, including overnights.
• Residence within 380 miles of the territory serviced.

Responsibilities

• Manage development and maintenance of provider relationships and agreements.
• Lead provider performance teams and oversee financial performance.
• Collaborate with internal stakeholders to drive quality and affordability.
• Ensure CMS and company policy compliance.
• Support Stars and Risk Adjustment goals.
• Travel as required.

Skills

Communication

Analytical skills

Negotiation

Time management

Team player

Willingness to travel

Education

Bachelor's degree in Business or related field

Master's degree, MBA or related

Tools

Excel

Job description

Remote

AL - Birmingham

MS - Biloxi

MS - Hattiesberg

FL - Pensacola

AL - Huntsville

AL - Montgomery

AL - Mobile

Full time

R0055302

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 plan subject 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.

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. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities.

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. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment.

HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations.

Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions.

Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas,

Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association

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