About the role

  • Provider Network Consultant at HCSC focused on provider relationship management and compliance. Responsible for educating and evaluating providers to meet contractual obligations.

Responsibilities

  • Developing and maintaining cooperative working relationships with the contracting provider community
  • Educating, training, researching problems
  • Identifying trends and evaluating providers to ensure contractual and financial requirements are adhered to and performed

Requirements

  • Bachelor’s degree in health care or business administration or a minimum of 4 years work experience in a managed care environment
  • Minimum of 2 years of health care administration experience in clinical and financial settings, with direct provider communication experience
  • Effective interpersonal, analytical, presentation and communication skills
  • Knowledge of the health care industry and BCBSIL private business
  • Ability and willingness to travel within assigned areas for responsibility, including overnight stays
  • Extensive knowledge of contracts, applications, and products
  • Demonstrated proficiency in provider reimbursement methods
  • Working knowledge of claims processing systems
  • Effective organizational and planning skills
  • Ability to take initiative and work independently
  • Demonstrated ability to meet deadlines and work well under pressure
  • Working knowledge of software, including Microsoft Office

Benefits

  • Health and wellness benefits
  • 401(k) savings plan
  • Pension plan
  • Paid time off
  • Paid parental leave
  • Disability insurance
  • Supplemental life insurance
  • Employee assistance program
  • Paid holidays
  • Tuition reimbursement

Job title

Provider Network Consultant

Job type

Experience level

JuniorMid level

Salary

$55,900 - $123,500 per year

Degree requirement

Bachelor's Degree

Location requirements

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