Principal Network Management Consultant

Health Care Service Corporation - Richardson, TX

Full-time

Richardson, TX

Insurance Carriers and Related Activities

About the position

At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career. This position is responsible for provider recruitment and contracting of physicians, physician groups, and facilities including large or complex groups/facilities such as large independent hospital systems, integrated and non-integrated systems, and Value Based Contracting. The role involves developing and negotiating contracts, maintaining relationships with providers, and ensuring strategic coverage for the assigned territory. Additionally, the position is responsible for educating providers and providing ongoing service, while also offering subject matter expertise to improve efficiencies and results. The ideal candidate will have a strong background in provider contracting, with a focus on negotiating reimbursements, financial arrangements, and rates. This role requires extensive knowledge of provider and facility contracting, products, and claims/processing systems. The ability to build relationships and negotiate effectively is crucial, as is the capacity to meet deadlines and work well under pressure. Strong verbal and written communication skills are necessary to interact with all levels of corporate personnel and providers. Proficiency in Microsoft Office and analytical skills to assess financial data are also important. The position requires the ability and willingness to travel within assigned areas of responsibility, including overnight stays.

Responsibilities

• Responsible for provider recruitment and contracting of physicians, physician groups, and facilities.
• Develop and negotiate contracts with providers and facilities.
• Maintain relationships with providers to ensure strategic coverage for assigned territory.
• Educate providers and provide ongoing service to improve efficiencies and results.
• Provide subject matter expertise in provider contracting and negotiations.

Requirements

• Bachelor's Degree and 4 years of provider contracting experience OR Master's Degree and 3 years of contracting experience OR 8 years of business experience including 4 years of provider contracting experience.
• Extensive knowledge of provider and facility contracting, products, and claims/processing systems.
• Strong negotiation skills and relationship building skills.
• Knowledge of the marketplace and ability to meet deadlines under pressure.
• Excellent verbal and written communication skills to interact with corporate personnel and providers.
• PC proficiency, including Microsoft Office.
• Analytical skills and business acumen to analyze financial data and determine the financial impact of negotiations.
• Ability and willingness to travel within assigned areas of responsibility, including overnight stays.

Nice-to-haves

• Commercial contracting (PPO, HMO) experience preferred.
• Knowledge of Value Based Contracting.