Health Care Service Corporation

Sr. Manager Payment Integrity Strategy and Operations

Health Care Service Corporation  •  $102k - $184k/yr  •  United States (Onsite)  •  3 hours ago
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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.

This Position Is Responsible For Leading The Process Leaders/Process Stewards In Planning, Defining, Developing, Testing, Documenting, Analyzing Results And/Or Implementing Process Improvement And Process Reengineering Opportunities. Leading And Supporting Business Process Activities And Methods To The Super Process Leaders/Process Steward. Leading Team Activities, Deliverables, And Issue Resolution. Leading Key Activities Including Data Collection, Metric Definition And Analysis, And Root Cause Analysis. Supporting Development And Evolution Of Hcsc Business Process Management Methodology Identifying Best Practice Standards, Guidelines, Procedures And Tools For Analyzing, Designing, And Implementing Business Process Initiatives. Ability To Travel.

Job Requirements

  • Bachelor’s degree and 8 years of experience in health care quality improvement, health care accreditation, health care operations, or combination thereof OR 12 years of experience in health care quality improvement, health care accreditation, health care operations, or combination thereof, including 8 years of experience in the health insurance industry with large, multi-state payer(s).
  • 3 years of leadership or management experience.
  • Experience with Continuous Quality Improvement (CQI) concepts, Strategy, and Change Management concepts.
  • Experience with external accrediting agency requirements (i.e., NCQA, URAC, AAAHC) and history of success in achieving accreditation.
  • Experience providing support to senior-level staff in process re-engineering and strategic problem-solving.
  • Analytical skills and negotiation skills.
  • Verbal and written communication skills including leadership skills, organizational skills and detail-orientation, interpersonal skills, consensus building skills, professional presentation skills and decision-making skills.
  • Experience preparing documentation for auditors or project management
  • Knowledge and understanding of the health care industry and regulatory requirements.
  • Experience writing policies and procedures.
  • Written and verbal communication skills.
  • Ability and willingness to occasional travel.

Preferred Job Requirements:

  • Payment integrity operational processes and strategy

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

$102,000.00 - $184,300.00

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

Health Care Service Corporation

About Health Care Service Corporation

Health Care Service Corporation serves nearly 23 million people across the United States through its portfolio of health benefit solutions.

HCSC provides health coverage options for employers large and small, individuals and families, and Medicare and Medicaid plans. HCSC also offers related health care products and services such as pharmacy solutions, life and dental insurance, and health data technology. A Mutual Legal Reserve Company, HCSC is an independent licensee of the Blue Cross Blue Shield Association.

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.

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Industry
Healthcare & Social Services
Company Size
10,000+ employees
Headquarters
Chicago, IL
Year Founded
Unknown
Website
hcsc.com
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