Divisional Vice President Enterprise Network Operations

At HCSC, building a talent engine for the future is a key priority because we recognize that as our business evolves to reflect the changing world, we must adapt our workforce to meet this challenge. Additionally, with "excellence" one of our core values, we are focused on improving our success measures and delivering the best possible customer experience.

This position is responsible for population health management operations across all lines of business (group, retail, government) and all HCSC plans (Illinois, Texas, Oklahoma, New Mexico, and Montana); developing reporting systems and ongoing operational capabilities for all alternative provider engagement models; delivering operational audits and controls for reimbursement arrangement payment models; communicating to internal and external stakeholders regularly about HCSC's value based care and/or alternate provider engagement model operational processes and performance; conducting oversight of the development of policies and procedures in accordance with compliance and quality standards; developing and implementing technical and operational enhancements for maintaining and improving population health operations; ensuring staff meets/exceeds goals, objectives and standards and have successful outcomes on projects and initiatives; communicating across the designated network operations; representing the department in internal meeting and with external entities.

• Bachelor Degree and 12 years operational experience in the health care industry.
• 5 years management experience, including oversight of management/upper management.
• Experience developing strategies and implementation of strategies /initiatives with successful outcomes.
• Leadership skills to work across departments, lead professional and management staff, represent the department in internal and external meetings and drives results.
• Knowledge of health insurance and network operations; must be familiar with the value based care and alternative provider reimbursement arrangements.
• PC proficiency including Word, Excel, PowerPoint and Access
• Experience with project management involving multi-functional team members
• Experience in interacting and influencing diverse interest groups including providers, regulators, other health plans, members and staff.
• Knowledge of State and Federal laws and regulations pertaining to providers.
• Clear and concise verbal and written communication skills including interpersonal and presentation skills.
• Experience with the insurance environment including trends in philosophy, theory, and applications concerning all products and services.

• Masters Degree

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Requirements: Expertise Network Management / Provider Relations Job Type Full-Time Regular Location IL - Chicago

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