Network Management Consultant - Provider - DFW and East TX

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

This position is responsible for supporting HEDIS, STARS and financial provider performance and contracting activities to ensure strategic provider coverage within an assigned territory, including contract negotiations for physicians, physician groups, and small to mid-size hospitals, while providing support for more complex hospital and physician contracting initiatives. The role develops and maintains strong provider relationships, delivers ongoing provider education and service, and serves as a trusted partner to drive HEDIS, STARS, risk adjustment, and value-based care performance.

Success in this role requires a consultative, data-driven professional who can engage providers, identify performance improvement opportunities, develop and execute action plans, leverage analytics to influence outcomes, and adapt strategies to achieve client goals in a rapidly evolving healthcare environment. Ability and willingness to travel within the assigned territory, including overnight stays, is required.

We have two available positions.

- one supporting the Dallas Fort Worth market and one supporting East, TX which would include Tyler, Longview and surrounding areas.

• Bachelor Degree and at least one year experience developing and negotiating provider contracts OR 5 years managed care operations experience handling independent work with at least one year experience developing and negotiating provider contracts.
• Meet deadlines and work well under pressure.
• Verbal and written communication skills, organizational and planning skills.
• PC proficiency to include Microsoft Office.
• Analytical skills.
• Ability and willingness to travel within assigned territory, including overnight stays

• Bachelor Degree in Business.
• Previous HEDIS and/or CMS STARs experience
• Solid understanding of health insurance, customer messaging/design and project management
• Expert level of Excel preferred (knowledge of pivot tables, VLOOKUP, etc.).
• Experience in financial/trend analysis
• Team player with proven ability to foster and manage working relationships within a matrix environment to obtain buy-in and drive results.
• Experience with EMRs and population health tools, including provider outreach to facilitate access, retrieval of medical records and chart notes, and compliant handling of Protected Health Information (PHI) in accordance with HIPAA requirements.

• Client-site
  
  Location:
  
  This is a field based position in either the Dallas Fort Wroth or East, TX market. The individuals will be onsite at provider offices up to 3 days a week and work from home typically 2 days a week.
• Schedule:
  
  Monday - Friday, typical business hours with infrequent evening and weekend meetings.
• Sponsorship:
  Sponsorship is not available

Compensation: $55,900.00 - $

Exact compensation may vary based on skills, experience, and location

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

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