Senior Provider Relations Representative - Remote

Health Care Service Corp.; United States; Remote; USD 63,000 - 114,000; Full time

Job summary

Health Care Service Corporation (HCSC) seeks a Provider Relations Specialist to develop and maintain cooperative relationships with providers and improve ease of doing business with HCSC. This role involves educating providers, addressing concerns, tracking issues, and ensuring performance aligns with operational and financial requirements.

It requires strong negotiation skills and travel within the assigned region.

Qualifications

• Bachelor’s degree in business or 6 years leadership experience.
• 4 years’ experience in claims, customer service, physician office or hospital setting.
• 3 years’ experience in provider relations including contracting and reimbursement issues.

Responsibilities

• Develop and maintain cooperative relationships with providers to support network performance.
• Educate and train providers; address provider concerns and escalate issues.
• Monitor provider performance to ensure operational and financial requirements are met.

Skills

Negotiation

Provider relations

Independent work

Education

Bachelor’s degree

Tools

Microsoft Office

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 providing support, as well as developing and maintaining cooperative working relationships with providers while facilitating and enhancing provider ease of doing business with HCSC. This includes establishing and maintaining provider relationships to support network performance, serving as a resource and point of escalation for provider concerns, issue tracking and resolution, educating and training providers, identifying trends, and evaluating provider performance to ensure operational and financial requirements are met.

Required Job Qualifications

Bachelor’s degree in business OR 6 years leadership experience. 4 years’ experience in claims, customer service, physician office or hospital or healthcare environment. 3 years’ experience in a position which requires in-depth physician/provider relations, including but not limited to, contracting and reimbursement issues. Ability to negotiate and contract with healthcare providers. Platform skills; organizational and planning skills; and ability to take initiative and work independently. Ability to multi-task; meet deadlines and work well under pressure. Ability and willingness to travel within assigned areas of responsibility, including overnight stays. PC proficiency to include Microsoft Office.

Preferred Job Qualifications

Bachelor’s degree and 3 years of work experience in managed care, or a minimum of 5 years’ work experience in a managed care environment. Minimum of 2 years of health care administration experience in clinical and financial settings, with direct provider communication experience. Effective interpersonal, analytical, presentation and communication skills. Ability and willingness to travel within assigned areas for responsibility, including overnight stays. Knowledge of contracts, applications, and products. Understanding of provider reimbursement methods. Working knowledge of claims processing systems. Effective organizational and planning skills. Analytical skills. Ability to take initiative and work independently. Demonstrated ability to meet deadlines and work well under pressure. Clear and concise interpersonal, verbal and written communication skills. Collaboration skills resulting in business/process improvements/changes. PC experience and skills to include Word, Excel, PowerPoint, etc. Demonstrated success building and maintaining relationships with physician groups, hospitals, and provider leadership. Experience conducting provider education, training, and face‑to‑face consultations. Extensive Medicaid and Medicare Advantage experience. Knowledge of healthcare contracting, reimbursement methodologies, and managed care operations. Prior territory management experience. Knowledge of BCBSTX claims processing systems.

Additional Details – Client‑site Location

This is a field‑based position in the Austin Texas market that requires provider office visits.

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.

This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii.

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.

Base Pay Range $63,300.00 - $114,300.00. 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.

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.