Senior Manager Prof Provider Network Performance - Work From Home

HCSC Group; United States; Hybrid; USD 93,000 - 168,000; Full time

Job summary

HCSC seeks a Senior Manager to develop and maintain provider relationships, negotiate agreements, and lead Provider Performance teams. You will drive quality, affordability and member satisfaction while supporting Stars and Risk Adjustment goals.

This field-based role requires travel and frequent engagement with provider offices across the Alabama, Southern Mississippi, and Florida Pan Handle territories. Onsite 3 days/week, remote 2 days/week.

Qualifications

• Bachelor’s Degree in Business or related field plus four years of health care administration or managed care experience; eight years may substitute.
• Demonstrated verbal and written communication skills with all levels of staff and providers.
• Demonstrated analytical abilities and proficient planning skills.
• Demonstrated negotiation skills and ability to meet deadlines under pressure.
• Team oriented with strong collaboration across matrix environments.
• Willingness to travel, including overnight stays.

Responsibilities

• Develop and maintain harmonious working relationships with assigned providers and negotiate provider agreements.
• Lead staff through training, coaching, performance management and other supervisory activities.
• Oversee provider network performance, engage with stakeholders to drive quality, affordability and member satisfaction.
• Support CMS Stars and Risk Adjustment goals and ensure compliance with CMS and company policies.

Skills

Verbal communication

Written communication

Analytical abilities

Negotiation

Time management

Team player

Willingness to travel

Education

Bachelor's Degree in Business

Master's degree / MBA

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.

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

Compensation: $92,700.00 - $167,500.00

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

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. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

To learn more about available benefits, please click https://careers.hcsc.com/totalrewards