Health Care Service Corporation - United States

Seeking a Clinical Practice Consultant (RN, PA, or NP) in Albuquerque, NM. This field-based role drives quality improvement by collaborating with medical practices to enhance HEDIS measures within value-based care models. You will leverage your managed care expertise to conduct clinical assessmen...

Lead high-value provider contract negotiations and strategy as Sr. Manager Key Provider Contracts at HCSC in Nashville. Direct business plans for top partners, leveraging 7+ years of healthcare or insurance experience and strong financial acumen. Drive critical negotiations, cross-functional enga...

Lead Payment Integrity Strategy & Operations at HCSC in Chicago, Richardson, or other key locations. Drive process re-engineering, CQI, and accreditation success (NCQA, URAC) with 8+ years in health insurance operations. Manage teams, analyze root causes, and implement best-practice business proc...

Join our team as an Associate Underwriter in Chicago, Downers Grove, or Richardson. You'll quote and rate proposals, approve cases, and apply math and problem-solving skills. We require a Bachelor's degree or 2 years of business experience, plus proficiency in Word and Excel. Ideal candidates hav...

Seeking a detail-oriented **Reimbursement Analyst I** to join our team in Tulsa, Richardson, Chicago, or Albuquerque. You will develop critical reports using **SAS**, build pricing models for network negotiations, and maintain the PREMIER Pricer. Ideal candidates possess a Bachelor’s degree, 3+ y...

HCSC seeks a Medical Director in Nashville to lead clinical strategy for HealthSpring Supplemental Benefits. Leverage 5+ years of clinical experience and board certification to improve underwriting tools and case reviews. Ideal for a physician (M.D./D.O.) with strategic thinking and analytical sk...

Join HCSC in Chicago as an Internal Auditor I. Leverage your Bachelor’s in Accounting or Finance to conduct audits of financial and operational controls, ensuring compliance with policies. We seek candidates with audit skills, project management abilities, and a willingness to learn risk methodol...

Join our Tulsa team as a Customer Advocate I, handling inbound calls in a dynamic call center environment. You'll assist members and physicians with inquiries, requiring a high school diploma and 6 months of customer service or office experience. Enjoy comprehensive benefits including medical, de...

Join HCSC as a Principal Division Strategy Consultant in Chicago, Richardson, or Tulsa. Drive divisional short- and long-term planning, execute business strategies, and analyze competitive market data. Requires a Bachelor’s degree and 6+ years in healthcare or strategic consulting. Ideal for lead...