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HCSC

Offers health insurance and wellness programs

Executive Director - Provider Contracting

UnderwritingConfirmed live in the last 24 hours
ContractRemote in USA

About the Job

Requirements

  • A bachelor's degree and 15 years of experience in health care or insurance administration, hospital or health care contracting, and hospital or physician relations, or 19 years of experience in those areas without the degree.
  • Seven years of management experience.
  • Knowledge of hospital and provider reimbursement strategies and policies.
  • Verbal and written communication skills to represent the company externally, negotiate contracts, resolve issues, and prepare executive and employee presentations.
  • Ability to work cross-functionally with colleagues in a highly matrixed environment.
  • Accuracy and sound judgment regarding financial matters, including contract performance and impact.
  • Negotiation skills.
  • Experience working in a fast-paced environment and meeting deadlines.
  • Ability to oversee annual budgets and allocate resources for projects and operational needs.
  • Ability to translate needs and initiatives into compelling business cases.
  • Ability to conduct cost-benefit analyses to justify investments and ensure return on investment.

Responsibilities

  • Develop and manage contracting strategies for commercial and government network operations.
  • Develop, negotiate, and successfully complete reimbursement contracts, ensuring network adequacy for commercial and government networks.
  • Develop networks, draft reimbursement agreements, and negotiate reimbursement contracts for hospitals, large professional groups with special pricing, and hospital-based physicians for commercial and government networks.
  • Achieve competitive advantage in discounts and access through contract negotiations and effective relationship management.
  • Develop strategies, draft agreements, and negotiate contracts for newly recognized provider categories.
  • Oversee analysis and reporting required to develop reimbursement strategies, and take corrective action as needed.
  • Resolve issues and contractual disputes.
  • Ensure staff meets or exceeds goals, objectives, and initiatives; ensure staff is trained, positions are filled, and employees receive communications about changes.
  • Manage budget, operational reporting, and financial reporting.
  • Communicate effectively and professionally with coworkers, management, and customers.
  • Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies, and other applicable corporate and departmental policies.
  • Maintain confidentiality of company-related business.
  • Communicate developments within assigned areas of responsibility to the Vice President of Network Management and perform special projects as requested.
  • Travel as required.

Desired Qualifications

  • An MBA or master's degree in Health Administration.

About the Company

HCSC

Offers health insurance and wellness programs

HCSC is a health insurance provider active in Illinois, Montana, New Mexico, Oklahoma, and Texas. It sells health insurance plans to individuals, families, and businesses, funding its services through member premiums. The company works by offering a range of plans tailored to different needs and by investing in wellness programs and care initiatives aimed at improving member health and reducing overall costs. Compared with others, HCSC emphasizes its long history, broad regional footprint, and its focus on quality care, cost management, and wellness-driven outcomes, distinguishing itself through sustained service and programs that support healthier living. Its goal is to help people live healthier lives by delivering reliable coverage, improving member outcomes, and controlling healthcare costs.

Company size
Not listed
Company stage
Not listed
Total funding
$511.7M
Headquarters
Chicago, IL
Founded
1936

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