From Home Rf Optimization Jobs in Illinois (NOW HIRING)

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Job SummaryThis position is responsible for developing business plans and provider network strategies across all lines of business - Commercial, ACA, Medicare, and Medicaid - and partnering with cross-functional leadership to execute them. This leader will lead the design, optimization, and long-term planning of HCSC's provider networks to balance financial discipline, quality, and access across lines of business. This leader will leverage insights from provider contracting, performance management, leading practices, and market innovations to shape ambitious expansion and financial strategies that position HCSC as a market leader. This leader will manage matrix relationships with key enterprise areas and ensure that executive strategy translates into measurable business outcomes by driving alignment and delivery across high-priority initiatives.

Job Responsibilities:

1. Manage team responsible for multiple lines of business / Plan Geographies / provider network strategy development and assist leadership as needed

2. Conduct ideation around line of business provider network strategies and evaluate new ideas and concepts against goals, objectives and operational capabilities. Ensure initiatives are measured against outcomes and business impact, not activity. Track results against business plans and strategies and provide executive level reporting to leadership.
3. Develop market, competitive and internal analytics in support of provider network strategy development across all lines of business.

4. Lead the development of clear and compelling deliverables that present work approach and results to multiple internal/external audiences, in presentations, reports, dashboards, etc.

5. Keep abreast of best practices and strategic trends in health-care products and industry in general.
6. Ensure team compliance with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
7. Communicate and interact effectively and professionally with co-workers, management, customers, etc.
8. Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
9. Maintain complete confidentiality of company business.
10. Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.

JOB REQUIREMENTS:
* Bachelor degree and 8 years of experience in health care, health insurance, or strategic consulting environment
* 5 years management experience
* Experience with strategic planning, strategy development, analytics and research
* Experience leading and mentoring staff
* Clear and concise verbal and written communication skills
* Experience with interacting successfully with senior management and staff across multiple departments
* Organizational skills, including ability to prioritize tasks
* Creativity and innovation, analysis and implementation skills and experience
* Business acumen and project/process integration skills.

*Overseeing the annual budget and allocating resources for various projects and operational needs.

*Translating needs and initiatives into compelling business cases.

*Conducting cost-benefit analyses to justify investments and ensure ROI.

PREFERRED JOB REQUIREMENTS:
* MBA or MHA
* Health care industry experience

* Experience with regulated markets (ACA, Medicaid, and Medicare Advantage)

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*Please note: This is a Telecommute (Remote) role. Remote employees must live within the continental United States, excluding Alaska, California, Hawaii or New York. Sponsorship is not available

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From 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, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range$121,200.00 - $225,200.00

Exact compensation may vary based on skills, experience, and location.