Provider Network Consultant

HCSC

Illinois, US
Base: $55,900.00 - $123,500.00; bonus/equity: annu...
Fully remote
Provider relationship management
Health insurance policy issues
Contractual and financial requirements
This position is responsible for identifying, researching, resolving, and informing the Provider Performance staff and other divisions, and the external provider community about HealthSpring policy issues, system and contractual changes

Job Summary

  • This position is responsible for identifying, researching, resolving, and informing the Provider Performance staff and other divisions, and the external provider community about HealthSpring policy issues, system and contractual changes.
  • Establishes and maintains relationships between HealthSpring and its providers to promote and ensure that issues are identified and resolved in a timely manner.
  • At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to your employees to support their life outside of work.

Matching Summary

This position is responsible for identifying, researching, resolving, and informing the Provider Performance staff and other divisions, and the external provider community about HealthSpring policy issues, system and contractual changes.

Salary

Base: $55,900.00 - $123,500.00; Bonus/Equity: annual incentive bonus plan; Benefits: robust total rewards package

Skills & Requirements

Must-have

  • Provider relationship management
  • Health insurance policy issues
  • Contractual and financial requirements
  • Physician onboarding
  • Provider reimbursement methods

Nice-to-have

  • Professional development investment
  • Purpose-driven company culture
  • Independent decision support

Key Requirements

  • Bachelor’s degree or 4 years managed care experience
  • 2 years health care administration experience
  • Direct provider communication experience
  • Knowledge of health care industry
  • Ability to travel within assigned areas
  • Extensive knowledge of contracts
  • Working knowledge of claims processing systems

Work Rights

Not specified

Tailored Resume

Cover Letter