Sr Payment Integrity Consultant - Payment Integrity

Health Care Service Corp.; Chicago (IL); Hybrid; USD 70,000 - 126,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

Health Care Service Corp. is seeking a PI Project Implementation professional to drive delivery with cross-functional teams. You will report on status, risks, and KPIs, and identify new payment integrity opportunities to maximize ROI.

The role offers a Flex Hybrid schedule (3 days in office, 2 days remote) and includes participation in an annual incentive plan. Strong communication and Microsoft Office skills are essential.

Qualifications

• Bachelor's degree and 3 years of business requirements experience, or 7 years in health insurance operations.
• Knowledge of and experience in payer operations.
• Implementation experience.
• Clear and concise interpersonal, verbal and written communication skills.
• PC proficiency with Microsoft Access, Excel, Word and PowerPoint.

Responsibilities

• Drive implementation of PI-owned projects and report status and risks.
• Identify new payment integrity opportunities with cross-functional teams.
• Track and report KPIs and impact metrics for PI initiatives.
• Draft communications on PI project progress, impact, value, and ROI.

Skills

Interpersonal communication

Communication (verbal)

Written communication

Payer operations

Education

Bachelor's degree

Tools

Microsoft Access

Microsoft Excel

Microsoft Word

Microsoft PowerPoint

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 driving implementation of PI-owned projects, reporting status and risks. While working with cross-functional teams, responsible for identifying new payment integrity opportunities. Responsible for tracking and reporting KPIs and impact metrics, working with the PI Program Manager to draft communications on PI project progress, impact, value, and ROI.

Required Job Qualifications

• Bachelor's degree and 3 years of business requirement experience OR 7 years of business requirements experience in health insurance operational functions or relevant experience
• Knowledge of and experience in payer operations
• Implementation experience
• Clear and concise interpersonal, verbal and written communication skills
• PC proficiency with Microsoft applications including access, excel, word and power point

Preferred Job Qualifications

• Healthcare background
• Project Management experience
• Experience managing vendor contracts
• Advanced excel experience

This is a Flex (Hybrid) role: 3 days in office; 2 days remote.

Pay Transparency Statement

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.

• 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

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.

Flex employees are expected to be in the office a minimum of three days a week. Management will have discretion to modify an employee's weekly schedule for exigent circumstances.

Base Pay Range $69,800.00 - $125,900.00 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.

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. We are a drug-free and smoke-free workplace.

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.