Senior Network Management Consultant

🕒 2 days ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $61.5k - $136.1k / year

⏰ Full Time

🟠 Senior

💼 Consultant

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Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Health Care Service Corporation serves nearly 23 million people across the United States through its portfolio of health benefit solutions.

📋 Description

• Managing a complex and high-volume caseload of Senate Bill 1264 (SB 1264) disputes involving out-of-network providers. • Leading negotiation strategy and resolution efforts for both informal and formal disputes. • Ensuring alignment with regulatory requirements, contractual standards, and statutory deadlines. • Providing guidance on case strategy, escalation paths, and resolution approaches. • Driving timely, compliant, and financially sound outcomes while maintaining operational excellence.

🎯 Requirements

• Bachelor Degree and 3 years provider contracting experience OR 7 years business experience including 3 years provider contracting experience. • Knowledge of provider and facility contracting, products, and claims/processing systems. • Negotiation skills. • Relationship building skills. • Knowledge of marketplace. • Meet deadlines and work well under pressure. • Verbal and written communication skills; organizational and planning skills. • PC proficiency to include Microsoft Office. • Analytical skills. • Ability and willingness to travel within assigned areas of responsibility, including overnight stays.

🏖️ Benefits

• 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