Network Management Consultant - Provider Performance

About the role

HCSC is hiring a Network Management Consultant focused on provider performance in the Houston market. The role supports HEDIS, STARS and financial provider performance and contracting activities to secure strategic provider coverage in an assigned territory, including contract negotiations with physicians, physician groups and small to mid-size hospitals, and support for more complex hospital and physician contracting. It is a field-based position with travel within the territory, including overnight stays.

Key responsibilities

• Negotiate contracts for physicians, physician groups and small to mid-size hospitals
• Support complex hospital and physician contracting initiatives
• Develop and maintain strong provider relationships and deliver ongoing provider education and service
• Act as a trusted partner to drive HEDIS, STARS, risk adjustment and value-based care performance
• Engage providers, identify performance improvement opportunities, develop and execute action plans and use analytics to influence outcomes

Required profile

• Bachelor's degree and at least one year of experience developing and negotiating provider contracts, or 5 years of managed care operations experience handling independent work plus one year of contract negotiation experience
• Ability to meet deadlines and work well under pressure
• Verbal and written communication, organizational and planning skills
• Willingness to travel within the assigned territory, including overnight stays

Required skills

• Analytical skills
• PC proficiency including Microsoft Office
• Preferred: previous HEDIS and/or CMS STARs experience, solid understanding of health insurance, customer messaging/design and project management
• Preferred: expert-level Excel (pivot tables, VLOOKUP), financial/trend analysis, EMRs and population health tools, and HIPAA-compliant handling of PHI

What we offer

• Base pay range of $63,300 to $114,300, varying with skills, experience and location
• Annual incentive bonus plan subject to its terms and conditions
• Schedule Monday to Friday, typical business hours, with infrequent evening and weekend meetings; onsite at provider offices up to 3 days a week and remote 2 days a week
• Benefits such as health and wellness, 401(k), pension, paid time off, paid parental leave, tuition reimbursement and more