Principal Consultant – Medicare Provider Network Strategy

🔥 6 minutes ago

🇺🇸 United States – Remote

💵 $92.7k - $167.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💼 Consultant

🦅 H1B Visa Sponsor

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Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Health Care Service Corporation is an independent licensee of the Blue Cross Blue Shield Association, serving nearly 23 million people across the United States with a wide range of health benefit solutions. The company provides health coverage options for various groups, including employers, individuals, families, as well as Medicare and Medicaid plans. In addition to health insurance, HCSC offers services such as pharmacy solutions, life and dental insurance, and health data technology. With nearly a century of experience, HCSC is dedicated to improving access to quality care, enhancing health outcomes, and reducing costs while maintaining a deep commitment to its members and local communities.

📋 Description

• Assist with leading short-term and long-term initiatives related to Medicare Advantage provider network strategy • Support and lead major, complex, and strategic network initiatives from inception to completion • Analyze Medicare network data using internal and external sources • Support prioritization of divisional initiatives and track progress toward goals • Assist the leadership team with executing the business plan, strategies, analytics, and data needs for the division • Work with divisional leadership on strategies and business plans for strategic network initiatives • Identify and present network trends and insights • Interact with all levels of cross-functional management, including senior divisional leadership • Work directly with corporate leadership • Drive results across departments in a matrixed environment

🎯 Requirements

• Bachelor’s degree and 6 years’ experience in health care, health insurance, or strategic consulting environment OR Bachelor degree and 5 years consulting experience involving strategic planning, business development and financial management operations OR 8 years of experience strategic planning, market research, network management, or product development in health care industry • Experience leading and formulating strategy with the ability to build strong connections with people and teams • Ability to work within a very fast-paced, quickly evolving organization and manage multiple, complex priorities • Ability to work directly with corporate leadership • Ability to drive results by working across departments in a matrixed environment • Interpersonal skills, including presentation, written and verbal communication • Experience with business analytics and information synthesis • Knowledge of strategic planning techniques and industry trends • Analytical, program management, and problem-solving skills • Advanced degree such as Juris Doctor, MBA, or MHA preferred • Health insurance or healthcare industry experience supporting Medicare Advantage preferred • Advanced knowledge of Medicare Advantage provider networks, key performance indicators, trends, and financial acumen preferred • Knowledge of Medicare Stars, Medicare Risk Adjustment, Medicare Finance, and Medicare Plan types preferred • Strong executive-level communication, presentation, and writing skills preferred • Experience digesting and solutioning for complex conceptual and operational problems preferred • Aptitude for analytical up and downstream thinking, information seeking, openness to learn, and thoroughness/detail orientation preferred • Must be able to work remotely within the continental United States, excluding California, New York, Alaska, and Hawaii

🏖️ Benefits

• Curated development plans and professional development opportunities • 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 • Annual incentive bonus plan • Other incentives • Equal opportunity employment • Drug-free and smoke-free workplace