Sr Payment Integrity Consultant - Payment Integrity

Health Care Service Corporation; Chicago (IL); Híbrido; USD 70.000 - 126.000; Tempo integral

Benefícios oferecidos por esta vaga

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

Resumo da vaga

Health Care Service Corporation (HCSC) is seeking a results‑driven professional to drive the implementation of PI‑owned projects, report status and risks, and collaborate with cross‑functional teams to deliver initiatives on time and within scope.

The role focuses on identifying new payment integrity opportunities, tracking KPIs and impact metrics, and drafting clear communications on project progress, ROI and value for stakeholders and senior leaders.

Qualificações

• Bachelor's degree or equivalent with 3+ years in health insurance operations or 7 years of business requirements experience.
• Knowledge of payer operations and implementation experience.
• Clear and concise interpersonal, verbal and written communication skills.
• Proficiency with Microsoft Office applications (Access, Excel, Word, PowerPoint).

Responsabilidades

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

Conhecimentos

Payer operations

Implementation experience

Interpersonal communication

Formação

Bachelor's degree or equivalent

Ferramentas

Microsoft Access

Excel

Word

PowerPoint

Descrição da vaga

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

Work Arrangement

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

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.

Benefits

• 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

Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

Salary and Incentives

Base Pay Range $69,800.00 - $125,900.00 Exact compensation may vary based on skills, experience, and location. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Schedule

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.

Equal Opportunity 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 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.