CrawlJobs Logo

Provider Management Consultant

hcsc.com Logo

Health Care Service Corporation

Location Icon

Location:
United States , Chicago

Category Icon
Category:

Job Type Icon

Contract Type:
Not provided

Salary Icon

Salary:

60300.00 - 133400.00 USD / Year

Job Description:

This role is responsible for supporting development and growth of positive, long-term relationships with physicians, providers, multi specialty clinics, and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Provider Vertical Leader works to identify the business plan and will have growth objectives. They will navigate the C Suite and execution of strategies in conjunction with the HCSC Contracting teams. assignments involves complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Job Responsibility:

  • Support development and growth of positive, long-term relationships with physicians, providers, multi specialty clinics, and healthcare systems to support and improve financial and quality performance within the contracted working relationship with the health plan
  • Identify the business plan and have growth objectives
  • Navigate the C Suite and execution of strategies in conjunction with the HCSC Contracting teams

Requirements:

  • Bachelor's Degree with 5-7 years experience in a Healthcare or Managed Care environment
  • 3 or more years of hands-on experience in Provider Contracting, Network Management, or Provider Relations
  • Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies
  • Demonstrated ability to manage multiple projects and meet deadlines
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences
  • Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance
  • Detail oriented professional with excellent written and verbal communication skills
  • CMS regulatory requirements, including Medicare Marketing Guidelines
  • Experience with Medicare products (including Medicare Advantage, Medicare Prescription Drug Plan (PDP) and Medicare Supplement products)

Additional Information:

Job Posted:
December 09, 2025

Employment Type:
Fulltime
Work Type:
Hybrid work
Job Link Share:

Looking for more opportunities? Search for other job offers that match your skills and interests.

Briefcase Icon

Similar Jobs for Provider Management Consultant

Senior Associate, Management Consulting

Your role as a Senior Associate will harness your passion for innovative technol...
Location
Location
United States , Southern California or Denver
Salary
Salary:
115000.00 - 140000.00 USD / Year
trace3.com Logo
Trace3
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Minimum of 5 years of related professional work experience preferably at a technology or consulting company
  • Strong client service skills are imperative
  • Strong understanding of Information Technologies and how a services organization works
  • Ability to listen, build rapport, and credibility as a strategic partner within business units
  • able to build bridges across teams and job functions
  • Demonstrates experience in program management, change management and continuous improvement
  • Highly organized, detail-oriented, excellent time management skills and able to effectively prioritize tasks in a fast-paced, high-volume, and evolving work environment
  • Ability to support customer requests with a proactive and consultative manner
  • listen and understand user requests and needs and effectively deliver
  • Comfortable managing multiple and changing priorities, and meeting deadlines in an entrepreneurial environment
Job Responsibility
Job Responsibility
  • Own and lead a project/program workstream including the status, timelines, communication, resource coordination and planning.
  • Continuously collect, gather and analyze project dimensions to identify risk, issues and or improvement opportunities and present details through compelling presentations
  • Continuously monitor and create transparency through the communication of project status, issues and risks to internal teams and our client
  • Provide customer service support for project resources and management team
  • Assist in the development of strategies to solve complex technical challenges
  • Proactively assist in the management of several clients, while reporting to Managers and above
  • Establish effective working relationships directly with clients
  • Contribute to the development of your own and the team’s technical acumen
  • Be actively involved in business development activities to help identify and research opportunities on new/existing clients
  • Continue to develop internal relationships and your Trace3 brand
What we offer
What we offer
  • Comprehensive medical, dental and vision plans for you and your dependents
  • 401(k) Retirement Plan with Employer Match, 529 College Savings Plan, Health Savings Account, Life Insurance, and Long-Term Disability
  • Competitive Compensation
  • Training and development programs
  • Major offices stocked with snacks and beverages
  • Collaborative and cool culture
  • Work-life balance and generous paid time off
  • Fulltime
Read More
Arrow Right

Commodity trading risk management strategy consultant

Global leading "Big Three" / MBB blue sky strategy consulting firms, with one of...
Location
Location
United Kingdom , London
Salary
Salary:
70000.00 - 150000.00 GBP / Year
bramwithconsulting.co.uk Logo
Bramwith Consulting
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Minimum of 3 years+ (ideally more) for Consultants and more for Senior Consultants, Managers etc, coming either from either a rival consultancy providing energy/commodity trading advisory consulting services OR from industry (energy trading firm) in an internal consultant role, Risk Analyst, Product Control Analyst, Trader or other business facing energy/commodity trading position
  • If coming from industry, you may have worked on the Graduate Rotational Scheme of an Oil & Gas or Utility Major gaining strong cross commodity and role experience, but be looking to move into a more Global role, gaining wider geographical and Front to Back Office knowledge
  • 70% of their projects are in Energy Trading (Power, Gas, LNG & Oil) so ideally you will have some Energy Trading experience, although you could instead have Metals Trading or Agricultural/Softs Trading experience
  • These roles are looking for the brightest and best, most dynamic energy/commodity trading consultants. You will need to showcase a track record of success throughout your CV/resume, including progression in your roles
  • Academics are very important to this consultancy, only hiring consultants with exceptionally strong academics (A*s, As and Bs at ALevel and 2:1 or 1st class degrees from world leading universities)
  • Flexibility on global travel is important, so you'll need to be keen to travel to Singapore, Dubai, Geneva, London, Houston etc for up to 1 week at a time to work on clientsite, but with plenty of flexible working from home opportunities when not on client-site
Job Responsibility
Job Responsibility
  • Developing marketing, sourcing, and trading strategies and business models to manage risks in commodity trading
  • Implementing commodity risk management operating models including governance, organization, business and risk processes, and IT systems
  • Promoting cross-industry expertise, tools, and perspectives to provide enhanced insights and capabilities
  • Transferring knowledge and ownership to clients' commodity trading and risk management organizations
  • Assessing trading performance through proprietary benchmarking tools
What we offer
What we offer
  • bonus + benefits
  • Fulltime
Read More
Arrow Right

Management Consultant

Efficientivity is seeking Management Consultants to support clients in implement...
Location
Location
Salary
Salary:
Not provided
efficientivity.com Logo
Efficientivity LTD
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor’s degree in business, management, or related field
  • Strong communication and analytical skills
  • Up to 3 years of relevant experience (preferred)
  • Passion for business improvement and client success
  • Ability to work independently and travel for client engagements
Job Responsibility
Job Responsibility
  • Guide clients through methodology implementation
  • Conduct workshops, assessments, and training sessions
  • Monitor progress and provide strategic recommendations
  • Collaborate with internal teams and document feedback
  • Travel to client sites as needed
What we offer
What we offer
  • Become part of a transformational movement in business improvement
  • Work with a dynamic network of professionals shaping the future of consulting
  • Gain exclusive Efficientivity certification, setting you apart in the industry
Read More
Arrow Right

Business Management Consultant

We have an exciting opportunity to join the team in Canada the role of Business ...
Location
Location
Canada
Salary
Salary:
Not provided
mclarens.com Logo
McLarens LLC
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Excellent communication and inter-personal skills
  • Deep and proven experience in a similar role
  • A proven track record of building strong working relationships, externally and internally
  • Strong stakeholder management with the ability to balance multiple deadlines
  • Personal pride in delivering outputs on time, with a focus on quality and communication
  • Supervisory experience
  • Be driven to meet and exceed targets
  • Prior experience within the insurance market and/or business development within a professional services environment will be highly advantageous
  • Successful candidates will be educated to degree level or equivalent with Lean Six Sigma competence
  • Team focused, with the ability to work independently as required
Job Responsibility
Job Responsibility
  • Conduct research to determine efficiency and effectiveness of managerial policies and programmes
  • Analyse and provide advice on the managerial methods and organisation of an establishment
  • Conduct quality audits
  • Develop quality management and quality assurance standards
  • Undertaking projects and other ad hoc work as required
Read More
Arrow Right

Senior Project Manager – Construction Consultancy

Fast paced, dynamic construction consultancy with offices across the UK are look...
Location
Location
United Kingdom , Manchester
Salary
Salary:
50000.00 - 60000.00 GBP / Year
https://brandonjames.co.uk Logo
Brandon James
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Strong pre & post contract experience
  • Construction Consultancy Experience as a Project Manager
Job Responsibility
Job Responsibility
  • Provide both pre and post contract roles with guidance from a Director
  • Run projects from inception through to completion
What we offer
What we offer
  • 25 days holiday
  • 6% pension contribution
  • Financial and practical support to help achieve MRICS status through completion of the APC
  • 5 hour working week
  • Clear career progression
  • Exposure to variety of million pound projects
  • Invaluable experience
  • Fulltime
Read More
Arrow Right

Senior Change Management Consultant

Our client is looking for a Senior Change Management Consultant for a 3 month co...
Location
Location
Canada , Toronto
Salary
Salary:
Not provided
https://www.randstad.com Logo
Randstad
Expiration Date
February 15, 2026
Flip Icon
Requirements
Requirements
  • 7+ years experience Demonstrated ability to develop and implement new operational processes that align with regulatory requirements and organizational objectives
  • 7+ years experience Proven experience in project management (e.g., project goals, risk, scope, planning, cost and quality management) and leading organizational change management initiatives
  • 7+ years Experience with process improvement concepts (e.g., Six Sigma, Lean)
  • 7+ years Experience collaborating with various groups to gather updates and maintain progress reporting, action items, risk management updates, etc.
  • 7+ years Experience working alongside project and program managers in a highly complex environment with internal and external stakeholders, vendors and partners
  • while providing updates, escalating where required, identifying risks, and leading project document deliverables
  • 7+ years Working knowledge of Ontario personal health information privacy legislation and regulation (i.e. Personal Health Information Protection Act, 2004)
  • 7+ years Public sector experience, ideally in Canadian healthcare in acute care, primary care and/or community care settings
  • 7+ years Knowledge and understanding of pan-Canadian and Ontario digital health standards and compliance testing practices
  • Excellent analytical, problem-solving and decision-making skills
Job Responsibility
Job Responsibility
  • Conduct requirements gathering, develop documentation, including presentations and briefing notes and conduct partner engagement
  • Work with different partners and subject matter experts from different backgrounds (clinical, business, and technical)
  • Interact with the business partners and subject matter experts in order to understand their requirements through gathering, documenting, and analyzing business and technology needs and requirements
  • Ensure all documentation follows drafting, approval, and publication standards, is version controlled and loaded onto central project sites
  • Follow-up on team member commitments and proactively identify risks
  • Assist Program Manager with preparation of the communication and training artifacts and tracking Organizational Change Management activities
  • Provide assistance to program manager and team in coordinating, planning, communicating, and executing the delivery of core program components
  • Proactively identify potential risk events and issues before they occur so that proper mitigating strategies can be developed
  • Assist in the preparation of status reports
  • Identify problems/issues and escalate as appropriate
What we offer
What we offer
  • Earn a competitive rate within the industry
Read More
Arrow Right

Legal Document Management Consultant

At Affinity Consulting Group we help law firms transform: Their business through...
Location
Location
United States
Salary
Salary:
75000.00 - 115000.00 USD / Year
affinityconsulting.com Logo
Affinity Consulting Group
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Minimum 3 years of direct, hands-on experience implementing and supporting NetDocuments or iManage in law firms or legal departments
  • Direct experience setting up DMS platforms for legal teams
  • Comfort working with integrations and add-ons
  • Confidence leading client discovery, best practices, and solution framing
  • Strong project and time management skills, with the ability to scope, track, and deliver your own work
  • Experience training end-users and creating clear, effective user documentation
  • A collaborative, detail-oriented mindset and clear communication style
  • Ability to build trust with clients and internal stakeholders
Job Responsibility
Job Responsibility
  • Guide law firms and legal teams through the implementation of document management systems like NetDocuments and iManage
  • Configure document management systems based on client workflows, including setting up add-ins and integrations to support seamless, connected work environments
  • Lead or support discovery sessions to understand client goals and translate them into clear, actionable system designs
  • Collaborate with teammates and vendor partners on system setup, data migration, testing, and go-live readiness
  • Deliver live and remote training sessions and create clear user guides to support adoption and reduce support volume
  • Provide hands-on support during go-live and ongoing roadmap planning post-launch
  • Act as a trusted advisor to clients by building long-term relationships and anticipating system improvement needs
  • Contribute to internal tools, delivery processes, and reusable assets to help the team scale and improve
What we offer
What we offer
  • Health & dental insurance
  • LTD/STD and life insurance
  • 401(k) matching
  • Employee Assistance Program
  • Professional development budget
  • Health & wellness stipend
  • Flexible PTO
  • Fulltime
Read More
Arrow Right

Oracle BRM (Billing & Revenue Management) Consultant

Cognizant is seeking a highly skilled and experienced Oracle BRM (Billing & Reve...
Location
Location
United States
Salary
Salary:
Not provided
inabia.com Logo
Inabia Solutions & Consulting
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Proven hands-on implementation and configuration experience with Oracle BRM (Billing & Revenue Management)
  • Must have direct experience in industries such as Telecom, Media, Utilities, or Subscription Services
  • Strong understanding of customer lifecycle management, including: Real-Time Rating & Charging (RTC), Prepaid and Postpaid Billing Systems, Invoice Generation, Discounting and Promotions, Payment Processing
  • Technical proficiency with key BRM components like Pipeline Manager (PLM), Customer Center (BCC), Billing Care, and Real-Time Charging
  • Experience with BRM data models, opcodes, and PCM C++.
  • Ability to write and debug stored procedures, and work with BRM APIs.
  • Excellent communication skills and the ability to work effectively in a remote setting.
  • Must be legally authorized to work in the United States without the need for employer sponsorship.
Job Responsibility
Job Responsibility
  • Analyze client business requirements and design scalable, robust billing architectures using Oracle BRM.
  • Configure and customize the Oracle BRM platform to implement complex pricing models, including prepaid, postpaid, and hybrid billing scenarios.
  • Develop, integrate, and optimize rating, discounting, and invoicing pipelines to handle high-volume transaction processing.
  • Manage and automate the end-to-end revenue management cycle, from customer charging to revenue recognition.
  • Integrate Oracle BRM with other systems such as CRMs, order management, and ERP financial modules for a seamless data flow.
  • Perform advanced troubleshooting, debugging, and performance tuning of the BRM environment.
  • Provide expertise in upgrading, patching, and maintaining the BRM application stack.
  • Collaborate with cross-functional and client teams to ensure solutions meet business needs and are delivered effectively.
Read More
Arrow Right