Performance & Results Consultant

Located in Richardson, TX and within TX Managed Care Networks and Products - this position is responsible for partnering with the division and the Enterprise in identifying, validating, monitoring and reporting financial metrics, operational capabilities and continual process improvements across all areas influencing COST Results across the healthcare delivery continuum, must leverage codig skills to write queries in SQL. Provides guidance and support toward the division (process owners) and the Enterprise strategies and processes, and creates metric definition, and analysis, monitoring, documentation as well as root cause analysis, and best practices; assisting in the development and evolution of HCSC focused markets, business process and management methodology and ensuring appropriate application of best practice standards, guidelines, procedures and tools for analyzing, designing, and performance of business solutions, processes. Ensures and monitors execution of process improvements.

JOB REQUIREMENTS:
•Bachelor's Degree and 4 years' experience in managed care / health care insurance OR 8 year's healthcare related experience.
•3 years of data analytics creation and business metric development (leveraging analytic tools - SQL).
•Experienced in leadership of process improvement and project initiatives.
•Experience creating developing, analyzing, executing, and monitoring performance indicators in a dashboard / scorecard format.
•Experience working with all levels in the organization, leading projects and problem resolution.
•Analytical and organizational skills including experience in meeting deadlines.
•Experience using statistics and statistical analysis for decision making.
•Proficiency to include Excel, and/or other data analysis tools such as Tableau.
•Clear and concise verbal and written communication skills.

PREFERRED JOB REQUIREMENTS:
•SQL coding skills / develop queries.

•Bachelor's Degree in Actuarial, Mathematics, Health Care Administration or similar.
•Strong managed care background in HMO/PPO.
•Broad experience across or combination of Health Care Delivery, Health Care Management, Utilization Management, Network Management and/or Claims Processing (CPT, ICD10, Revenue Codes, UB Form, 1500 Form, etc).
•Demonstrated project delivery skills which include identifying issues, root cause analysis and driving projects to resolution.

Must be located in Richardson, TX.
Relocation is not provided at this time.
Visa sponsorship will not be provided now or in the future for this role.

•CA
LI-POST
•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 Actuarial, Analytics & Reporting, Physician, General Health Care, Government Programs, Network Management / Provider Relations, Other Job Type Full-Time Regular Location TX - Richardson


Meet Some of HCSC's Employees

Allison M.

Internal Auditor

Allison audits operational and financial data throughout the business, helping to expose and mitigate risks, ensure compliance, and add value to HCSC’s operations as a whole.

Rosa Y.

Claims Examiner

Rosa works to process claims that stop due to system edits—researching the edits, correcting the errors, and completing the claims to help members and providers get paid.


Back to top