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Medicaid Contract Consultant - Claims

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
Is responsible for leadership and coordination of the assigned Medicaid programs in accordance with contractual and regulatory requirements. Implementing program changes related to claims, billing and reimbursement and working with other areas of the organization on the development, testing and implementation. Responsible for organization and management of process and system changes to ensure the requirements of the assigned Medicaid program are met. Serves as SME of provider reimbursement methodologies, Medicaid rates and fee schedules. Serves as the liaison with vendors and internal functional areas and assists in the coordination of the contract with state regulatory agencies.

Please note: This is a hybrid role and will work in the office three days a week.

Required Job Qualifications:
Bachelor Degree and 4 years' experience in contract management OR 8 years' experience in contract management.
Leadership experience
Project management/planning skills.
Experience in a position requiring independent and critical decision making skills.
Experience communicating with and relationship building with internal business units and/or various external government agencies.
Experience leading/providing guidance to intra and interdepartmental staff.
Experience accurately documenting information reported.
Organizational, analytical and decision-making skills.
Negotiation skills resulting in business/process improvements/changes.
Clear and concise interpersonal, verbal and written communication skills.
Presentation skills.
Project positive, professional image.

Preferred Job Qualifications:
Experience with corporate policies / procedures, compliance regulations in health care administration/managed care experience.

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.

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Job Posting: 11832719

Posted On: Apr 15, 2024

Updated On: Apr 20, 2024

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