at Health Care Service Corporation in Chicago, Illinois, United States
Job Description
At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.
Come join us and be part of a purpose driven company who is invested in your future!
Job Summary
This position is responsible for Value Based Care and New Network strategy and development activities at an advanced consultative level to enhance market stance, competitive capabilities and profitability. Responsible for the identification, evaluation and development of innovative network / care management solutions; direction and expansion of Value Based Care provider contracting (Patient Center Medical Home, ACO, Bundled Payment models); identification and evaluation of competitive provider pricing models, high economic value and Performance Based Reimbursement programs; assessment of new network opportunities and value propositions; and development, promotion and presentation of network advantages/strengths.
JOB REQUIREMENTS:
Bachelor Degree and 6 years managed care or network management experience at the Health Plan level or 10 years managed care or network management experience at the Health Plan level.
Experience in provider contracting and negotiations.
Experience in financial analysis related to provider reimbursement, payment methodologies and provider performance measures.
Innovation and strategy skills
Consultative skills
Analytical skills and experience developing analytical presentation and pricing models.
Clear, concise and effective verbal and written communication skills including interpersonal and presentation skills
Strategic Thinking, Critical Thinking and problem solving skills
Business acumen and ability to build credibility with all levels of the organization
Financial acumen
Independence, resourcefulness and ability to meet deadlines
Knowledge of healthcare benefits, terminology and concepts.
Experience developing and presenting to executives or provider groups; strong delivery skills.
Knowledge of network management trends and innovations.
Ability to collaborate effectively with stakeholders and key internal partners.
PREFERRED JOB REQUIREMENTS:
Master Degree
Experience in use of membership data, premium data and/or claims data.
Knowledge of State and Federal laws and regulations.
Experience with network management pricing modeling
Experience in innovation
Please note: This role will work in the office three days a week.
We encourage people of all backgrounds and experiences to apply.Even if you don't think you are a perfect fit, apply anyway - you might have qualifications we haven't even thought of yet
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
HCSC Employment Statement:
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.
BCBSTX complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
