Provider Network Consultant

Job ID: CH-1019123 Description:

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.

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 email us here to request reasonable accommodations.

Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "my account" and click on "View your job submissions".

BASIC FUNCTION:

This position is responsible for developing and maintaining cooperative working relationships with the contracting provider community; educating, training, researching problems; and identifying trends and evaluating providers to ensure contractual and financial requirements are adhered to and performed.

JOB REQUIREMENTS:

  • Bachelor Degree OR 4 years experience in a managed care environment.
  • 2 years experience in health care administration, clinical or financial setting.
  • Experience in or knowledge of provider reimbursement methods and claims processing systems.
  • Knowledge of health care contracts, applications, and products.
  • PC proficiency to include Microsoft Word, Excel, PowerPoint and health care databases.
  • Verbal and written communications skills to include interpersonal and presentation skills.
  • Analytical, organizational and planning skills.
  • Ability to take initiative and work independently.
  • Ability to meet deadlines and work well under pressure.
  • Ability and willingness to travel, including overnight stays.

PREFERRED JOB REQUIREMENTS:

  • Bachelor Degree in Health Care or Business Administration.

LI-POST

  • CA
  • CB*

Requirements: Expertise Network Management / Provider Relations Job Type Full-Time Regular Location IL - Chicago


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