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Prin Div Strategy Consultant - Governance (Remote)

Role overview

Qualifications

  • Bachelor’s degree and 6 years’ experience in health care, health insurance, or strategic consulting environment
  • Experience leading and formulating strategy with the ability to build strong connections with people and teams
  • Interpersonal skills, including presentation, written and verbal communication
  • Experience with business analytics and information synthesis

Responsibilities

  • Overall accountability for ensuring that field contractors comply with contracting standards and regulatory requirements
  • Provide direct and ongoing guidance and support to field contractors on contracting standards and LOB regulations
  • Support field contractors on non-standard issues and work closely with Legal, Compliance, and Matrix Leadership
  • Work within the Governance Department responsible for Network Standards, Systems, and Contracting Governance

Key facts

Hard skills

Other skills

  • Strategic Planning
  • Negotiation
  • Social Skills
  • Communication
  • Problem Solving
  • Relationship Management

About the company

Health Care Service Corporation logo

Health Care Service Corporation

Health Insurance (Payers)

Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), is an Independent Licensee of the Blue Cross and Blue Shield Association. We are the largest customer-owned health insurer in the United States, serving more than 18.6 million members through our Plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. For nearly a century, we have enabled and coordinated the access to quality care for millions of members. Our experience and industry knowledge establishes a solid foundation for our future—driving innovations that further expand access, improve health outcomes, and reduce costs. Embedded within the fabric of how we operate is a deep sense of caring and commitment that informs how we serve our members, engage in local communities, and deliver positive change to the health care industry. As health care needs evolve, we leverage our portfolio of companies to deliver differentiated value to all industry stakeholders so that, together, we make more possible. Join HCSC and discover what new ways of thinking can mean for you, your community, our customers and our organization: HCSC.com/careers. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to an inclusive, 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, gender, national origin, disability, or protected veteran status.

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size10001

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Job description

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

Overall accountability for ensuring that field contractors comply with contracting standards, regulatory requirements, including use of governing standard templates, reimbursement standards, network and contract policy, and the non-standard deviation process. Provide direct and ongoing guidance and support to field contractors on contracting standards, LOB regulations, and use of the Contract Management System (Contract Manager). Supports field contractors on non-standard issues and works closely with the Legal, Compliance, and Matrix Leadership on policy, language, and "ability to administer" issues as well as on reporting and compliance with the Governance non-standards review process.
Work within the Governance Department responsible for Network Standards, Systems, Contracting Governance and Network Governance for Providers & Suppliers, in support of the broader NBS Organization and Work within the larger NBS Governance Team.

Required Job Qualifications:

  • Bachelor’s degree and 6 years’ experience in health care, health insurance, or strategic consulting environment
  • OR Bachelor’s degree and 5 years consulting experience involving strategic planning, business development, and financial management operations.
  • OR 8 years of experience strategic planning, market research, network management, or product development in health care industry.
  • Experience leading and formulating strategy with the ability to build strong connections with people and teams.
  • Drive results by working across departments in matrixed environment.
  • Interpersonal skills, including presentation, written and verbal communication.
  • Experience with business analytics and information synthesis.
  • Knowledge of strategic planning techniques and industry trends
  • Able to work within a very fast-paced, quickly evolving organization and manage multiple, complex priorities.
  • Work directly with corporate leadership.
  • Analytical, program management and problem-solving skills.

Preferred Job Qualifications:

  • Strongly preferred background in Compliance, Regulatory Ops, or Audit
  • Subject Matter Expertise in Contracting, Negotiating, Provider/Supplier Services, Project Management, Health Plan Operations, Health Plan Regulations, and Accreditation Standards.
  • High degree of business acumen & professionalism
  • Ability to translate complex conditions & identify solutions for risk mitigation.
  • Ability to foster collaboration, value other’s perspectives and gain support and buy-in for organizational proposals.
  • Matrix management skills & high levels of business acumen 
  • Ability to drive and lead an organization through change.
  • Excellent interpersonal and relationship management skills.

#LI-Remote

#LI-AS1

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 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.

Base Pay Range

$92,700.00 - $167,500.00

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

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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