Government Provider Networks Manager

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.

BASIC FUNCTION:

This position is responsible for managing, developing and maintaining the network strategy for Provider Networks and ensuring new and renewed contracts meet enterprise pricing and methodology standards, meet/exceed CMS & or State Network Adequacy requirements. This position is responsible for management of direct staff. This position is responsible for leading contract negotiations, and developing and maintaining relationships with providers.

JOB REQUIREMENTS:

• Bachelor Degree and 4 years health care administration/managed care experience OR 8 years health care administration/managed care experience
4 years' experience in managed care contracting, benefits administration or underwriting experience including contract negotiations
Leadership skills
Verbal and written communication skills to interact with all levels of corporate personnel and assigned providers
Analytical skills and reporting experience
Planning skills
Negotiation skills
Experience consistently meeting deadlines and working well under pressure
PC proficiency including Word, Excel, PowerPoint and databases
Experience developing and analyzing reports
Team player and people oriented
Ability and willingness to travel, including overnight stays

PREFERRED JOB REQUIREMENTS:

• Experience working with providers
Experience working with Government Program products and knowledge of the CMS Stars rating system
Experience and skilled in developing contract standards for pricing and methodology
Experience working with Government Programs risk and capitated based provider contracts
Bachelor degree
Demonstrated project management skills
Skilled in managing provider-facing (e.g., physician, hospital, etc.) communications, and or, provider relations

•This role will be based out of Chicago, Illinois.

•CA
•CB

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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