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Full-Time

Value Based Care Consultant

Vbc

Confirmed live in the last 24 hours

HCSC

HCSC

Health insurance provider in multiple states

Financial Services
Healthcare

Compensation Overview

$88.7k - $160.2kAnnually

Senior

Albuquerque, NM, USA

Hybrid position requiring in-office presence.

Category
Management Consulting
Consulting
Required Skills
Financial analysis
Requirements
  • Bachelor’s 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, negotiations and provider reimbursement.
  • Strong background in financial analysis, payment methodologies and provider performance measures.
  • Innovation.
  • Strategy, critical thinking, and problem-solving skills.
  • Master’s degree;
  • Experience in developing and writing value-based provider contracts.
  • Knowledge of network management pricing modeling and innovation.
Responsibilities
  • 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, specialty payment models, etc.); 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 and strengths.

HCSC provides health insurance services across five states: Illinois, Montana, New Mexico, Oklahoma, and Texas. The company offers a variety of health insurance plans designed for individuals, families, and businesses, ensuring that different healthcare needs are met. HCSC's plans work by collecting premiums from members, which then fund the healthcare services covered under these plans. What sets HCSC apart from other health insurance providers is its strong focus on health and wellness programs aimed at reducing overall healthcare costs and improving the health outcomes of its members. The goal of HCSC is to be a reliable partner in health, promoting quality care and supporting individuals in leading healthier lives.

Company Stage

N/A

Total Funding

$472.7M

Headquarters

Chicago, Illinois

Founded

N/A

Simplify Jobs

Simplify's Take

What believers are saying

  • The new Houston office will create numerous job opportunities, fostering local economic growth and community development.
  • The acquisition of Cigna's Medicare businesses will expand HCSC's product offerings and geographic reach, benefiting current and future members.
  • Recognition as one of the 'Best Places to Work in IT' and having a CEO listed among the 'Most Influential People in Healthcare' highlight HCSC's strong leadership and positive work environment.

What critics are saying

  • The $231,900 fine from the Illinois Department of Insurance for an inaccurate provider directory could damage HCSC's reputation and trust with members.
  • The integration of Cigna's Medicare businesses may pose operational challenges and potential disruptions.

What makes HCSC unique

  • HCSC's strategic expansion into local communities, such as the new Houston office, emphasizes its commitment to economic growth and local workforce development, setting it apart from competitors.
  • The acquisition of Cigna's Medicare businesses significantly enhances HCSC's capabilities and reach in the growing Medicare market, providing a competitive edge.
  • HCSC's collaboration with Feeding America to address root causes of hunger showcases its holistic approach to community health, beyond traditional healthcare services.

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