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.

Job Summary

This position is responsible for auditing operations compliance and regulatory requirements in assigned areas. Ensuring compliance across the plans, and State and Federal requirements. Researching and reporting monthly on trends. This will include monthly documented summaries, receipts, and how these impact audit requirements. Recommending and implementing technical and operational solutions as communicated to the management team. Gathering data, analyzing data, and preparing reports including disseminating information from various sources and systems. Supporting projects and initiatives and resolving issues by working with staff within the department or across departments.

Schedule: This is a Flex (Hybrid) role: 3 days in office; 2 days remote.

Required Job Qualifications:

• Bachelor’s degree and 2 years of insurance experience OR 6 years’ insurance experience. Knowledge of health care regulatory and legislative process; experience reading and interpreting legislation.
• Knowledge or experience reviewing accreditation standards and evaluating level of compliance, identifying challenges, and proposing solutions
• Knowledge or experience monitoring compliance and managing evidence documents.
• Experience preparing monthly reports and forecasting.
• Research skills.
• Analytical skills.
• Detail orientation and organizational skills; experience meeting deadlines on time.
• Ability and willingness to travel, including overnight stays.
• Clear and concise verbal and written communication skills.
• PC proficiency to include Word, Access, Excel, and Cognos.

Preferred Job Qualifications:

• Audit experience.
• Knowledge or experience in provider networks, credentialing and contracting.
• Knowledge or experience in enterprise PDM business rules.
• Knowledge or experience in NOSD internal systems (Vistar, PPW, CAQH, Salesforce).
• Ability to handle multiple projects in an environment of urgent and shifting deadlines.

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From 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, plus other incentives, we offer a robust total rewards package for employees.  Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement:

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, 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.

Base Pay Range

$39,900.00 - $88,800.00