Provider Network Consultant

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 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. Ability and willingness to travel, including overnight stays. Required Job Qualifications: *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. Preferred Job Qualifications: * Medicare and Medicaid managed care experience. *This is a hybrid role requiring 3 days in the office and 2 days remote weekly. 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. #LI-Hybrid #LI-EL1 #INJLF 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. Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities. Join our Talent Community. For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. 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 call us at 1-866-977-7378 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 "candidate home" to view your job submissions. Legal and Privacy Health Care Service Corporation is an Equal Opportunity Employment / Affirmative Action employer Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2022 Health Care Service Corporation. All Rights Reserved.