This position is responsible for coordinating the analysis and reporting of initiatives aimed at optimizing Government Program network adequacy performance. This position will coordinate initiatives to ensure that all HCSC plans maintain provider networks that are adequate based on CMS regulatory requirements and can support new and existing membership. Government networks must be capable of product offering expansions through geographical service area expansion and comply with all time, distance, and capacity standards. This position will track adequacy performance, communicate gaps, identify exceptions or areas of improvement, and will consult Plans on gap closure via either provider recruitment or provider data solutions. This position will consult Plans on improving provider data integrity. This position interfaces with various business teams to achieve goals and desired outcomes, developing a thorough understanding of business needs and coordinating them with the overall HCSC strategy; working closely with all customers to understand state specific environments and evolving industry needs to meet business goals.
Required Job Qualifications:
• Bachelor's Degree and 3 years business experience.
• Clear, concise verbal and written communication skills including interpersonal skills to communicate across departments and with all levels both internally and externally.
• Ability to present findings and status of projects, build relationships and garner information from various sources.
• Experience in a position that requires: a. Research / Analytical skills b. Project Management skills c. Problem Solving Skills d. Multi-tasking / Prioritization skills e. Relationship Building Skills
• Presentation and group facilitation experience
• Experience in MS Office products (including Word, Excel and PowerPoint)
Preferred Job Qualifications:
• Provider network management experience with provider contracting, provider communications, etc.
• Health insurance regulatory experience.
• Health insurance or healthcare industry experience.
• Experience in a position that required strategic planning techniques and application of industry trends.
• Master's 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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