Data Consultant jobs at HCSC - 38 jobs

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary The Healthcare Senior Analytics Consultant will be leading the development of technical and analytical enhancements to further improve HCSC Medicare Part D Star ratings. This role will be responsible for designing and developing advanced Stars reporting and dashboards related to the Medicare Stars program focused on Part D clinical, administrative, and customer experience measures. These reports will be utilized by business partners and Stars leadership in making critical business decisions related to enhancements to existing programs, development of new pilots and initiatives, and other opportunities to maximize Part D Stars affordability and enterprise value. The ideal candidate will have a strong strategic mindset for driving Part D quality and a passion for healthcare analytics. Required Job Qualifications * Bachelor's degree and 6 years of experience in health care services, statistical analysis, or insurance industry economics or related field OR Master's degree with 4 years of experience in health care services, statistical analysis, or insurance industry economics or related field OR PhD with 2 years of experience in health care services, statistical analysis, or insurance industry economics or related field OR 10 years of experience in health care services, statistical analysis, or insurance industry economics or related field * Understanding, and being highly proficient at querying a wide variety of internal and external data sources to get meaningful insights. * Strong analytical skills and proficiency in computer languages, such as SQL, Python, R, etc. * Ability to create a dynamic and visually engaging dashboard leveraging data visualization tools such as Tableau or Power BI * High degree of business intelligence and understanding how to take a business case from inception to customer or partner execution. * Experience leading an analytic initiative to success. * Excellent communication and presentation skills. * Ability to work independently and as part of a team. * Performance excellence in championing initiatives and collaborating with multiple stakeholders to bring the initiative to life. * Ability to work under pressure and delivery high quality output to senior leadership to decision making within short timeline. Preferred Job Qualifications: * Experience with project management methodologies. * Experience in Healthcare industry - Medicare STARS Part D data, Medication Adherence measures, CMS pharmacy data pharmacy and provider claims. * Experience with advanced analytics tools and languages such as Teradata, Databricks, GitHub, Python. * Experience with automation tools, such as Airflow, Alteryx. #LI-CH1 #LI-Flex INJLF 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 ************************************** The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject 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 $84,400.00 - $152,300.00 Exact compensation may vary based on skills, experience, and location.

Principal Marketing Strategy Consultant page is loaded## Principal Marketing Strategy Consultantlocations: Chicago Illinois HQ (300 E. Randolph Street): Richardson Texas HQ (1001 E. Lookout Drive)time type: Full timeposted on: Posted Yesterdayjob requisition id: R0047854At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.Join HCSC and be part of a purpose-driven company that will invest in your professional development.# # **Job Summary**### The Principal Marketing Strategy Consultant serves as the strategic operator and integrator for the DSVP of Marketing, driving alignment, coordination, and execution of the Marketing organization's highest priorities. This role partners closely with cross-functional marketing leaders and enterprise stakeholders to translate strategy into action, ensuring initiatives are clearly defined, aligned to business objectives, and delivered with rigor. Operating at the center of the Marketing organization, the Principal Consultant enables effective decision-making, accelerates execution, and ensures Marketing functions as a unified, high-performing team in support of enterprise goals. Required Job Qualifications: • Bachelor's degree / Master's Degree / MBA and 7 years of general industry experience or 3 years consulting experience at a top tier consulting firm • Strategy development/planning/implementation: Knowledge of corporate strategy and/or transformation core skill sets; experience formulating, planning, and/or implementing strategy and transformative efforts. • Analysis/synthesis/insight generation: Ability to conduct quantitative and qualitative analysis, provide insights and implications, inform decision making, and make recommendations/prioritize new opportunities to pursue. • Critical thinking/problem solving: Ability to proactively identify and resolve complex problems with some oversight. • Project management: Experience managing complex projects with some oversight. • Collaboration and interpersonal effectiveness: Ability to build strong connections with people and teams, drive results by working across the matrixed environment, and work directly with leadership with some oversight. • Communication skills: Ability to communicate effectively through verbal, written and visual channels. • Ability to work within a very fast-paced, quickly evolving organization and manage multiple, complex priorities. Preferred Job Qualifications: • Advanced degree such as MBA, MHA, MD, JD, or PhD • Experience in the healthcare industry, especially the health insurance sector • Experience with marketing #LI-CH1 #LI-Hybrid INJLFW### ### ### **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 .The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject 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**$112,200.00 - $202,600.00Exact compensation may vary based on skills, experience, and location.For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities.Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. #J-18808-Ljbffr

Principal Network Mgmt Cons page is loaded## Principal Network Mgmt Conslocations: IL - Chicagotime type: Full timeposted on: Posted Yesterdayjob requisition id: R0047015At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.Join HCSC and be part of a purpose-driven company that will invest in your professional development.# # **Job Summary**### This position is responsible for provider recruitment and contracting of Physicians, Physician Groups both large and small (IPA's, PHO's, large independent hospital systems, Integrated & non-Integrated systems, Value Based Contracting, Etc). Develop and negotiate contracts. Develop and maintain relationships with assigned providers. Ensure strategic coverage for all LOBs and maintain required adequacy for each LOB. The person in this position it is expected to be a SME in the department for multiple assigned areas.### **Job Requirements:*** Bachelor's degree and 4 years provider contracting experience OR Master's degree and 3 years contracting experience OR 8 years business experience including 4 years provider contracting experience. Contracting experience involves negotiating reimbursements, financial arrangements and rates.* Extensive 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 to interact with all levels of corporate personnel and providers.* PC proficiency to include Microsoft Office.* Analytical skills and business acumen to analyze financial data to determine financial impact of negotiations.* Ability and willingness to travel within assigned areas of responsibility, including overnight stays.**This is a Flex (Hybrid) role: 3 days in office; 2 days remote.**#LI-MW2 #LI-Hybrid### ### **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 .The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject 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**$90,900.00 - $164,200.00Exact compensation may vary based on skills, experience, and location.locations: IL - Chicagoposted on: Posted 13 Days AgoFor more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities.Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. #J-18808-Ljbffr

Thank you for your interest in joining Solventum. Solventum is a new healthcare company with a long legacy of solving big challenges that improve lives and help healthcare professionals perform at their best. At Solventum, people are at the heart of every innovation we pursue. Guided by empathy, insight, and clinical intelligence, we collaborate with the best minds in healthcare to address our customers' toughest challenges. While we continue updating the Solventum Careers Page and applicant materials, some documents may still reflect legacy branding. Please note that all listed roles are Solventum positions, and our Privacy Policy: *************************************************************************************** applies to any personal information you submit. As it was with 3M, at Solventum all qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Description: Data Scientist for Medical Document Analysis (Solventum) 3M Health Care is now Solventum At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers' toughest challenges, we pioneer game-changing innovations at the intersection of health, material, and data science that change patients' lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue. We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you. The Impact You'll Make in this Role: As a Data Scientist specializing in medical document analysis, you will work at the forefront of healthcare NLP. You will design, implement, and evaluate advanced natural language understanding (NLU) systems that interpret complex clinical text and support data-driven medical decision making. This includes developing models grounded in transformers, generative AI, and research-oriented neural architectures. You will collaborate closely with clinical domain experts, fellow data scientists, ML engineers, and product teams to bring research prototypes into production systems. You will explore new modeling approaches, optimize training pipelines, and contribute to the long-term direction of Solventum's deep learning portfolio. You Will Make an Impact By: Scoping and designing NLP/NLU applications that support clinical understanding of medical documents and downstream healthcare workflows. Translating business and clinical requirements into mathematical and experimental criteria, ensuring models are measurable, reliable, and auditable. Processing, aligning, and enriching diverse structured and unstructured medical datasets for deep learning, LLMs, and agentic AI systems. Developing and evaluating deep learning models, including transformer-based architectures and neural architectures such as CNNs and attention mechanisms for capturing linguistic patterns in clinical text. Understanding and mitigating model weaknesses, including bias, drift, hallucination behavior, and robustness concerns. Designing experiments and error analyses that explain model behavior and enable clear communication with both technical and non-technical audiences. Deploying models into Solventum's cloud environment, partnering with ML engineering to ensure reliability, observability, and compliance within regulated healthcare systems. Staying current with emerging research in NLP/LLMs, evaluating new methods and identifying opportunities to advance Solventum's deep learning initiatives. Your Skills and Expertise To set you up for success in this role from day one, Solventum requires (at a minimum) the following qualifications: Master's degree or PhD in computer science, mathematics, or related fields or Bachelor's degree with at least 5 years of IT experience Solid experience in Python especially in deep learning for text analysis and libraries such as PyTorch and Transformers Solid grasp of statistics and exploratory data analysis US citizenship or permanent resident required Additional qualifications that will help you succeed in the role: Experience conducting research-driven NLP/NLU work involving representation learning, attention mechanisms, or hybrid neural architectures. Ability to self-organize across multiple technical and business contexts, communicating complex findings with clarity and confidence. Experience extracting insights from complex clinical datasets and presenting those insights to varied audiences. Familiarity with AWS, GitHub, CI/CD, and scalable ML deployment practices. Hands-on experience with LLMs, prompting, fine-tuning, or agentic AI frameworks. Experience with ETL of large-scale text using tools such as PySpark, Spark NLP, or distributed data frameworks. Exposure to clinical coding systems or medical terminologies (e.g., ICD, CPT, SNOMED) is a plus. Work location: Remote Travel: Relocation Assistance: Not authorized Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status). Supporting Your Well-being Solventum offers many programs to help you live your best life - both physically and financially. To ensure competitive pay and benefits, Solventum regularly benchmarks with other companies that are comparable in size and scope. Onboarding Requirement: To improve the onboarding experience, you will have an opportunity to meet with your manager and other new employees as part of the Solventum new employee orientation. As a result, new employees hired for this position will be required to travel to a designated company location for on-site onboarding during their initial days of employment. Travel arrangements and related expenses will be coordinated and paid for by the company in accordance with its travel policy. Applies to new hires with a start date of October 1st 2025 or later.Applicable to US Applicants Only:The expected compensation range for this position is $106,000 - $145,750, which includes base pay plus variable incentive pay, if eligible. This range represents a good faith estimate for this position. The specific compensation offered to a candidate may vary based on factors including, but not limited to, the candidate's relevant knowledge, training, skills, work location, and/or experience. In addition, this position may be eligible for a range of benefits (e.g., Medical, Dental & Vision, Health Savings Accounts, Health Care & Dependent Care Flexible Spending Accounts, Disability Benefits, Life Insurance, Voluntary Benefits, Paid Absences and Retirement Benefits, etc.). Additional information is available at: *************************************************************************************** of this position include that corporate policies, procedures and security standards are complied with while performing assigned duties. Solventum is committed to maintaining the highest standards of integrity and professionalism in our recruitment process. Applicants must remain alert to fraudulent job postings and recruitment schemes that falsely claim to represent Solventum and seek to exploit job seekers. Please note that all email communications from Solventum regarding job opportunities with the company will be from an email with a domain *****************. Be wary of unsolicited emails or messages regarding Solventum job opportunities from emails with other email domains. Please note, Solventum does not expect candidates in this position to perform work in the unincorporated areas of Los Angeles County.Solventum is an equal opportunity employer. Solventum will not discriminate against any applicant for employment on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status. Please note: your application may not be considered if you do not provide your education and work history, either by: 1) uploading a resume, or 2) entering the information into the application fields directly. Solventum Global Terms of Use and Privacy Statement Carefully read these Terms of Use before using this website. Your access to and use of this website and application for a job at Solventum are conditioned on your acceptance and compliance with these terms. Please access the linked document by clicking here. Before submitting your application you will be asked to confirm your agreement with the terms.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Responsible for analytical data needs. Handle complex data requests, reports, and predictive data modeling. Analyze health management programs including: data collection, validation and outcome measurement May include: Financial, pharmacy, claims, provider, and member data IRS, CMS, HHSC, HEDIS reporting Internal data cleansing and data reconciliation analysis Trend analysis in various functional areas of health care management Create and generate reports through MS-Excel, MS-Access, and SQL using Business Objects interface and direct links to core databases (ODS/EDW) Produce reports for and interface with senior management and internal and external stakeholders Gather and interpret business requirements and monitor data trends to proactively identify issues Execute data changes and update core systems as needed Handle multiple projects and timelines effectively and communicate risks and issues to manager regularly Assist with training lower level Data Analysts Performs other duties as assigned Complies with all policies and standards Education/Experience: Bachelor's degree's related field or equivalent experience. 2+ years of statistical analysis or data analysis experience. Bachelor's degree related field or equivalent experience. 2+ years of statistical analysis or data analysis experience or 1+ years of related IT experience, including data warehouse, coding or ETL experience. By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Pay Range: $56,200.00 - $101,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of value, develop solutions, and deliver insights to reduce overall cost of care for members and improve their clinical outcomes. Interpret and analyze data from multiple sources including healthcare provider, member/patient, and third-party data Support execution of large-scale projects with limited direction from leadership Identify and perform root-cause analysis of data irregularities and present findings and proposed solutions to leadership and/or customers Manage multiple, variable tasks and data review processes with limited supervision within targeted timelines Support the design, testing, and implementation of process enhancements and identify opportunities for automation Apply expertise in quantitative analysis, data mining, and the presentation of data to see beyond the numbers and understand how customers interact with analytic products Support multiple functions and levels of the organization and effectively, both verbally and visually, communicate findings and insights to non-technical business partners Independently engage with customers and business partners to gather requirements and validate results Communicate and present data-driven insights and recommendations to both internal and external stakeholders, soliciting and incorporating feedback when required Performs other duties as assigned Complies with all policies and standards Education/Experience: Bachelor's degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience. 2+ years of experience working with large databases, data verification, and data management, or 1+ years IT experience. Healthcare analytics experience preferred. Working knowledge of SQL/query languages. Preferred knowledge of programmatic coding languages such as Python and R. Knowledge of statistical, analytical, or data mining techniques including basic data modeling, trend analysis, and root-cause analysis preferred. Preferred knowledge of modern business intelligence and visualization tools. Experience in emerging trend analysis, financial modeling, claims pricing, contract/network analysis, and/or ROI evaluation preferred. Familiarity with claims payment, utilization management, provider/vendor contracts, risk adjustment for government sponsored healthcare desired. By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Pay Range: $56,200.00 - $101,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

**Become a part of our caring community and help us put health first** The Enterprise AI organization at Humana is a pioneering force, driving AI innovation across our Insurance and CenterWell business segments. By collaborating with world-leading experts, we are at the forefront of delivering cutting-edge AI technologies for improving care quality and experience of millions of consumers. We are actively seeking top talent to develop robust and reusable AI modules and pipelines, ensuring adherence to best practices in accountable AI for effective risk management and measurement. Join us in shaping the future of healthcare through AI excellence. We are building advanced agentic systems capable of autonomously managing and decomposing complex goals. We are seeking an expert in agent design, planning, and control to develop and evaluate agents that can set, adapt, and execute goals in dynamic, real-world environments. You'll contribute to the scientific and engineering foundations that make AI agents reliable, interpretable, and robust across long-horizon tasks. **Key** **R** **esponsibilities** + Architect goal setting and goal decomposition mechanisms for autonomous agents operating in uncertain or open-ended environments + Design and implement dynamic planning systems (e.g., hierarchical planning, curriculum learning, scratchpad/self-refinement loops) + Collaborate on memory, tool-use, and feedback-loop designs enabling multi-step, self-directed agent behavior + Develop evaluation frameworks for alignment with human intent, consistency, progress against long-horizon objectives + Prototype agents that interface with APIs, MCP servers, search engines, databases, or real-world actuators to pursue goals safely and efficiency + Explore mechanisms to detect and mitigate goal misalignment, looping behavior, or undesirable emergent strategies + Work across teams to integrate goal alignment with safety, alignment, and operational reliability mechanisms **Technical skills** + Proficiency in SQL, Python, and data analysis/data mining tools. + Experience with machine learning frameworks like Pytorch, Jax, LangChain, LangGraph or AutoGen + Experience with high performance, large-scale ML systems + Experience with language modeling with transformers + Experience with symbolic planning, causal reasoning, and model-based RL + Experience with large-scale ETL **Use your skills to make an impact** **Required Qualifications** + Master's Degree and 4+ years of experience in research/ML engineering or an applied research scientist position preferably with a focus on developing production-ready AI solutions + 2+ years of experience leading development of AI/ML systems **Preferred Qualifications** + Ph.D. in Computer Science, Data Science, Machine Learning, or a related field + Demonstrated experience shipping autonomous, or semi-autonomous agents in production or simulation + Experience with LLM-based agents with scratchpad/self-reflection or hierarchical task decomposition + Understanding of autonomy risk mitigation strategies, including off-switch protocols, or bounded rationality **Additional Information** **Location/Work Style:** Remote US **Why Humana?** At Humana, we know your well-being is important to you, and it's important to us too. That's why we're committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. Just to name a few: + Work-Life Balance + Generous PTO package + Health benefits effective day 1 + Annual Incentive Plan + 401K - Excellent company match + Well-being program + Paid Volunteer Time Off If you share our passion for helping people, we likely have the right place for you at Humana. **Work at Home Guidance** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested + Satellite, cellular and microwave connection can be used only if approved by leadership + Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **SSN Alert Statement** Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $142,300 - $195,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 02-27-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. By delivering solutions across spectrums of health care Optum is focused on our aspiration of improving experiences and outcomes for everyone we serve while reducing the total cost of care. In support of this, OptumInsight's purpose is to connect the health care system with trusted services, analytics and platforms that make clinical and administrative processes valuable, easy and efficient for everyone. OptumInsight provides analytics, research, consulting, technology and managed services solutions to hospitals, physicians, health plans, government agencies, life science companies and other industry partners. In addition to our many commercial clients, OptumInsight capabilities and technologies are leveraged by OptumHealth, OptumRx and our sister company UnitedHealthcare. As a Data Analyst, you will be working with Payment Integrity. Your primary responsibility will be to assist in the development and deployment of advanced analytics designed to detect claim overpayments across various platforms and lines of business. This will play a crucial role in enabling recovery and cost avoidance, significantly contributing to our overall organizational efficiency and success. You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. Primary Responsibilities: * Perform data analysis and generation activities for the investigations team including data extracts, summaries, random sampling, and special projects * Prepare Healthcare claims data for investigative business needs and work with investigations teams to better understand the content of the data sets * Establish and implement standard policies, procedures, processes and best practices across the company to promote compliance with applicable laws and contractual obligations * Produce, publish and distribute scheduled and ad-hoc client and operational reports relating to the development and performance of products, processes and technologies * Analyze and interpret data to identify trends, patterns and opportunities for the business and clients * Experience communicating complex information via phone conversations and emails to non-technical clients, external customers, internal customers and executives * Experience communicating current solutions to engineers and assist in prototyping, building, and testing new software You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * 5+ years of experience as a data analyst * 5+ years of experience writing SQL queries/scripts * 2+ years of experience with Python, Perl, or Ruby * 2+ years of Healthcare claims or payment processing experience * 1+ year of experience with selenium, postman, or other webscraping tools * 1+ years of VBA * Advanced Excel skills Preferred Qualifications: * Healthcare data analytics experience (Financial and Metrics based reporting) * Knowledge of cloud-based data warehousing environments * Knowledge of AI frameworks * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** This position is responsible for assisting with leading cross-functional VBC Contract operations team responsible for contract modeling/simulations, program and contract level assessments, operational readiness activities all in alignment with network contracting, driving business validation. Assisting the leadership team with driving VBC business priorities, Executive Operational reporting, and operational excellence across all the markets. Collaborating with several cross-functional teams, strategies, network contracting, provider operations and actuarial analytics needs for the division and working with divisional leadership on future state strategies and business plans for functional areas. Working with enterprise areas to ensure there is alignment with the divisional strategy and operational imperatives. **Required Job Qualifications:** + Bachelor 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. + Drive results by working across departments in 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 + Able to work within a very fast-paced, quickly evolving organization and manage multiple, complex priorities. + Work directly with corporate leadership. + Analytical, program management and problem solving skills. **Preferred Job Qualifications:** + Advanced degree such as Juris Doctor, MBA, or MHA. + Healthcare and Value Based Care knowledge. + Strong analytical, presentation, skills + Strong Microsoft Office Skills + Ability to present to Leadership complex modeling results. **This is a Flex (Hybrid) role: 3 days in office; 2 days remote.** \#LI-TELECOMMUTE \#LI-SG1 **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 ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject 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** $92,700.00 - $167,500.00 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** This position is hybrid (3 days a week in the office) This Position Is Responsible For Provider Recruitment And Contracting Of Physicians, Physician Groups And Facilities Including Large Or Complex Groups/Facilities (Large Independent Hospital Systems, Integrated & Non-Integrated Systems, Value Based Contracting, Etc). Develop And Negotiate Contracts. Develop And Maintain Relationships With Providers. Ensure Strategic Coverage For Assigned Territory. Responsible For Education Of Providers And For Ongoing Provider Service. Provide Subject Matter Expertise To Improve Efficiencies And Results. Job Description 1.Work with internal departments to ensure appropriate implementation of executed agreements.2.Analyze financial reports to determine financial impact of negotiations.3.Develop and negotiate agreements with providers and facilities (including large independent hospital systems, integrated & non-integrated systems, value based contracting, etc.) within assigned territory of responsibility. 4.Responsible for maintaining a professional relationship with key provider groups. Ensure effective liaison and rapport is developed and maintained through meetings, correspondence and telephone calls.5.Ensure strategic objectives are being met with regard to physicians, physician groups and facilities needed for assigned territory(s). Ensure appropriate provider services including working across departments to resolve issues. 6.Oversee the servicing of facilities, large groups, and/or capitated entities to include assisting with eligibility and capitation issues, contracting issues, and bonus arrangements. Serves as a liaison between internal departments and the capitated entity.7.Work with delegated entities to ensure that providers are loaded correctly. Work closely with the delegation oversight department regarding the delegated entity reporting requirements to include claims delegation, utilization management delegation and credentialing delegation.8.Respond to provider inquiries in an effective and timely manner and assist in claims resolution and payment problems. Must work closely with the Pricing, Full Service Units, Utilization Management, Medical, Delegation Oversight, Core Credentialing, Provider Automation and other divisions within the company.9.Provide leadership regarding negotiation of rates for traditional and managed care business. Conduct and assist in the negotiation process and assure that providers are kept informed of pertinent changes in policies and procedures. Coordinate appropriate education/in-servicing is provided for providers. Education may pertain to managed care and areas where pertinent rulings/regulations could affect business.10.Explain corporate policies and procedures to contracted providers; counsel with provider's staff to ensure their familiarity with Blue Cross procedures.11.Establish and maintain relationships with assigned providers through personal visits, correspondence and telephone calls.12.Serve as a mentor/teacher regarding the activities of staff.13.Serve on local and corporate committees and task forces that require input from Network Management Department. Participate in trade association meetings, as required. 14.Transform fee for service contracts to fee for value.15.Develop reports and analyze performance outcomes. 16.Ensure all expenditures comply with corporate and divisional expense guidelines.17.Communicate and interact effectively and professionally with co-workers, management, customers, etc.18.Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.19.Maintain complete confidentiality of company business.20.Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested. JOB REQUIREMENTS: *Bachelor Degree and 4 years provider contracting experience OR Master degree and 3 years contracting experience OR 8 years business experience including 4 years provider contracting experience. Contracting experience involves negotiating reimbursements, financial arrangements and rates. *Extensive 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 to interact with all levels of corporate personnel and providers. *PC proficiency to include Microsoft Office. *Analytical skills and business acumen to analyze financial data to determine financial impact of negotiations. *Ability and willingness to travel within assigned areas of responsibility, including overnight stays. **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 ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject 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** $90,900.00 - $164,200.00 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** The Consultant's primary responsibility is to leverage strong technical skills and healthcare industry knowledge to support clinical and business stakeholders. This role will be accountable for the analytical support and consultancy of internal/external customers, as well as advisory service for internal/external senior leaders. **Requir** **ed Job Qualifications:** + Bachelor's degree and 2 years of experience in health care services, statistical analysis, or insurance industry economics or related field ORMaster's degree in related field OR 6 years of experience in health care services, statistical analysis, or insurance industry economics or related field + Understanding, and being highly proficient at querying a wide variety of internal and external data sources to get meaningful insights. + Performance excellence in computer languages, such as SQL, R, Python. + Ability to create a dynamic and visually engaging dashboard leveragingdata visualization tools such as Tableau or Power BI. + High degree of business intelligence and understanding how to take a business case from inception to customeror partner execution. + Excellent communication and presentation skills. + Ability to work independently and as part of a team. + Performance excellence in championing initiatives and collaborating with multiple stakeholders to bring the initiative to life. **Preferred Job Qualifications:** + Experience with project management methodologies. + Experience of Healthcare industry - payor, provider, claims, pharmacy, public health, epidemiology, etc. + Experience with version control/collaborative tools, such as GitHub + Experience with automation tools. **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 ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject 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** $61,500.00 - $136,100.00 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** Job Purpose: This position is part of the Center for Responsible AI and AI Governance support function and is responsible for the execution of activities to support the enterprise AI Governance program. Responsible for creating and maintaining AI governance operational dashboards to track and monitor projects in the AI governance process. This role collects, organizes, analyzes, and reports information to management, and supports the evolution of the AI governance processes, policies, and procedures. **Required Job Qualifications:** **Bachelor's degree and 2 years of experience in health care services, statistical analysis, or insurance industry economics or related field OR Master's degree in related field OR 6 years of experience in health care services, statistical analysis, or insurance industry economics or related field** **Understanding, and being highly proficient at querying a wide variety of internal and external data sources to get meaningful insights.** **Ability to create a dynamic and visually engaging dashboard leveraging data visualization tools such as Power BI.** **Excellent communication and presentation skills.** **Ability to work independently and as part of a team.** **Performance excellence in championing initiatives and collaborating with multiple stakeholders to bring the initiative to life.** **Preferred Job Qualifications:** **Three (3+) year's experience in a data and analytics role where strong detail orientation was required.** **Two (2+) years of experience in data visualization and building dashboards, particularly with Power BI.** **Strong Proficiency in MS Excel, and PowerPoint.** **Project management skills, including planning, execution, monitoring, and closing projects, as well as needs assessment, solution design, and recommendations.** **Familiarity with AI and governance concepts.** **Effective time management, prioritization, and decision-making skills.** **Experience in defining success criteria and establishing metrics/KPIs.** **Understanding of IT/IS laws and regulations (e.g., HIPAA) and governance frameworks (e.g., NIST, COBIT, ITIL, HITRUST).** **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 ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject 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** $61,500.00 - $136,100.00 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** This position is responsible for supporting the development, performance management, and oversight of their assigned provider networks in the OH market territory. The Network Management Consultant will work to build and maintain strong relationships with their assigned provider networks to help impact key performance metrics that benefit the members we serve. Ability and willingness to travel within assigned territory, including overnight stays as needed. Key responsibilities: *Establishing and managing strong, solid relationships with assigned provider groups and their staff (e.g. physicians, practice managers, care coordination teams), as well as executing with provider group on initiatives that benefit the customer, provider, and health plan *Educating providers on the performance requirements associated with value-based contracts. *Conducting regular provider visits to educate providers and office staff on topics including, but not limited to: preventative and quality outcome metrics, risk adjustment, medical cost management, etc. *Understanding, developing, tracking, monitoring and reporting on key program performance metrics, such as utilization, coding, and Stars/quality performance. Required Job Qualifications: *Bachelor Degree and at least one year experience OR 5 years managed care operations experience handling independent work. *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 territory, including overnight stays Preferred Job Qualifications: *Bachelor Degree in Business. \#LI-SZ1 \#LI-Hybrid **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 ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject 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** $55,900.00 - $123,500.00 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** This position is responsible for functioning in a lead role in developing and implementing strategic goals of the department. Working as the liaison between department and all areas of HCSC. Providing leadership to the team that supplies project management expertise. Job Qualifications: + Bachelor's degree with 5 years healthcare and/or managed care insurance experience OR 7 years healthcare and/or managed care insurance experience. + Experience managing a department project or a portion of a divisional or corporate project, including analysis, strategy forming, developing project management plans, developing appropriate resources, managing project team, and implementation. + Experience independently managing to resolution complex issues across multiple divisions. + Experience leading/providing guidance to intra and interdepartmental staff. + Knowledge of current health care products, the external marketplace, and HCSC competition. + Knowledge of HCSC's various functions areas and departments. + Experience communicating with and relationship building with various external customers and providers. + Clear and concise interpersonal, verbal and written communication skills. + Negotiation skills resulting in business/process improvements/changes. + PC experience and skills to include Word, Excel, PowerPoint and Lotus Notes. + Facilitation, presentation and analytical skills. Preferred Job Qualifications: + Bachelor Degree in Healthcare Administration or Business Management. + 2 years of experience in healthcare contracting + Medicare knowledge **This is a Flex (Hybrid) role: 3 days in office; 2 days remote.** **Sponsorship is not available.** \#LI-MW2 \#LI-Hybrid **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 ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject 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** $61,500.00 - $136,100.00 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us to start **Caring. Connecting. Growing together.** Optum Serve Consulting/The Lewin Group (OSC/Lewin), a premier national health care and human services consulting and policy analysis firm, brings 50 years of experience finding answers and solving problems for leading organizations in the public, non-profit, and private sectors. In the wide-ranging field of health human services consulting, OSC/Lewin provides both depth and breadth of expertise. Currently, OSC/Lewin has more than 250 consultants drawn from industry, government and academia. They all share a solid commitment to OSC/Lewin's core values of objectivity, integrity, analytical innovation, vision, and dedication to client satisfaction. At OSC/Lewin, we help federal, state, and other decision-makers strengthen health and human services programs, make informed policy choices, and implement critical initiatives. The **Health Data Analytics Consultant** will provide support on a number of payment model implementation contracts requiring intermediate SAS, R, Python, or SQL experience as well as knowledge of statistics and research methodology. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. **Schedule:** Monday - Friday, daylight **Primary Responsibilities:** + Perform a broad range of quantitative analysis to inform the design, implementation, and evaluation of Medicare and Medicaid payment models + Support the development of payment calculations, conduct financial and trend analysis, calculate quality metrics, and perform fast-paced ad-hoc analysis to quickly address client needs + Work with clients to verify analysis parameters and specifications + Apply machine learning, econometrics/statistics, predictive modeling, return-on-investment analysis, simulation, and data visualization methods to support the development of health policy + Efficiently query large databases of healthcare claims and eligibility data + Write detailed specifications and documentation of data processing and analytical steps + Write effective and efficient code both independently and under the guidance of project managers using best practice quality control procedures + Maintain a consistently high degree of accuracy and attention to detail in all tasks + Work effectively and cooperatively as a member of a project teams + Prepare data and information for internal as well as external use, contribute to reports, and assist with project coordination tasks You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + 4+ years of experience in health/analytics related field + 4+ years of experience using SAS, R, Python, or SQL in a research, consulting, or business environment + Experience working with healthcare claims and enrollment data in large data warehouse environments + Experience in preparing data and information and contributing to reports and presentations + Familiarity with healthcare data/payment concepts (e.g., claims data structure/contents, claim types, payment concepts) + Proven excellent oral and written communication skills, strong interpersonal skills, and a focus on meeting deadlines **Preferred Qualifications:** + Academic coursework in statistics, econometric modeling, or other comparable coursework + SAS certification + Experience conducing statistical analysis to inform health policy + Experience with databases having complex structures and relationships, such as the Integrated Data Repository or Chronic Conditions Warehouse + Experience managing and analyzing large datasets using SAS grid and other parallel processing techniques + Experience with other software such as Excel (e.g., pivot tables, VBA) + Understanding of Medicare and Medicaid payment methodologies *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job SummaryThe Consultant's primary responsibility is to leverage strong technical skills and healthcare industry knowledge to support clinical and business stakeholders. This role will be accountable for the analytical support and consultancy of internal/external customers, as well as advisory service for internal/external senior leaders. Required Job Qualifications: Bachelor's degree and 2 years of experience in health care services, statistical analysis, or insurance industry economics or related field OR Master's degree in related field OR 6 years of experience in health care services, statistical analysis, or insurance industry economics or related field Understanding, and being highly proficient at querying a wide variety of internal and external data sources to get meaningful insights. Performance excellence in computer languages, such as SQL, R, Python. Ability to create a dynamic and visually engaging dashboard leveraging data visualization tools such as Tableau or Power BI. High degree of business intelligence and understanding how to take a business case from inception to customer or partner execution. Excellent communication and presentation skills. Ability to work independently and as part of a team. Performance excellence in championing initiatives and collaborating with multiple stakeholders to bring the initiative to life. Preferred Job Qualifications: Experience with project management methodologies. Experience of Healthcare industry - payor, provider, claims, pharmacy, public health, epidemiology, etc. Experience with version control/collaborative tools, such as GitHub Experience with automation tools. 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 ************************************** The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject 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$61,500.00 - $136,100.00 Exact compensation may vary based on skills, experience, and location.

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary The Consultant's primary responsibility is to leverage strong technical skills and healthcare industry knowledge to support clinical and business stakeholders. This role will be accountable for the analytical support and consultancy of internal/external customers, as well as advisory service for internal/external senior leaders. Required Job Qualifications: * Bachelor's degree and 2 years of experience in health care services, statistical analysis, or insurance industry economics or related field OR Master's degree in related field OR 6 years of experience in health care services, statistical analysis, or insurance industry economics or related field * Understanding, and being highly proficient at querying a wide variety of internal and external data sources to get meaningful insights. * Performance excellence in computer languages, such as SQL, R, Python. * Ability to create a dynamic and visually engaging dashboard leveraging data visualization tools such as Tableau or Power BI. * High degree of business intelligence and understanding how to take a business case from inception to customer or partner execution. * Excellent communication and presentation skills. * Ability to work independently and as part of a team. * Performance excellence in championing initiatives and collaborating with multiple stakeholders to bring the initiative to life. Preferred Job Qualifications: * Experience with project management methodologies. * Experience of Healthcare industry - payor, provider, claims, pharmacy, public health, epidemiology, etc. * Experience with version control/collaborative tools, such as GitHub * Experience with automation tools. 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 ************************************** The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject 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 $61,500.00 - $136,100.00 Exact compensation may vary based on skills, experience, and location.

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary Job Purpose: This position is part of the Center for Responsible AI and AI Governance support function and is responsible for the execution of activities to support the enterprise AI Governance program. Responsible for creating and maintaining AI governance operational dashboards to track and monitor projects in the AI governance process. This role collects, organizes, analyzes, and reports information to management, and supports the evolution of the AI governance processes, policies, and procedures. Required Job Qualifications: * Bachelor's degree and 2 years of experience in health care services, statistical analysis, or insurance industry economics or related field OR Master's degree in related field OR 6 years of experience in health care services, statistical analysis, or insurance industry economics or related field * Understanding, and being highly proficient at querying a wide variety of internal and external data sources to get meaningful insights. * Ability to create a dynamic and visually engaging dashboard leveraging data visualization tools such as Power BI. * Excellent communication and presentation skills. * Ability to work independently and as part of a team. * Performance excellence in championing initiatives and collaborating with multiple stakeholders to bring the initiative to life. Preferred Job Qualifications: * Three (3+) year's experience in a data and analytics role where strong detail orientation was required. * Two (2+) years of experience in data visualization and building dashboards, particularly with Power BI. * Strong Proficiency in MS Excel, and PowerPoint. * Project management skills, including planning, execution, monitoring, and closing projects, as well as needs assessment, solution design, and recommendations. * Familiarity with AI and governance concepts. * Effective time management, prioritization, and decision-making skills. * Experience in defining success criteria and establishing metrics/KPIs. * Understanding of IT/IS laws and regulations (e.g., HIPAA) and governance frameworks (e.g., NIST, COBIT, ITIL, HITRUST). 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 ************************************** The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject 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 $61,500.00 - $136,100.00 Exact compensation may vary based on skills, experience, and location.

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job SummaryThis position is responsible for supporting the development, performance management, and oversight of their assigned provider networks in the OH market territory. The Network Management Consultant will work to build and maintain strong relationships with their assigned provider networks to help impact key performance metrics that benefit the members we serve. Ability and willingness to travel within assigned territory, including overnight stays as needed. Key responsibilities: •Establishing and managing strong, solid relationships with assigned provider groups and their staff (e.g. physicians, practice managers, care coordination teams), as well as executing with provider group on initiatives that benefit the customer, provider, and health plan •Educating providers on the performance requirements associated with value-based contracts. •Conducting regular provider visits to educate providers and office staff on topics including, but not limited to: preventative and quality outcome metrics, risk adjustment, medical cost management, etc. •Understanding, developing, tracking, monitoring and reporting on key program performance metrics, such as utilization, coding, and Stars/quality performance. Required Job Qualifications: *Bachelor Degree and at least one year experience developing and negotiating provider contracts OR 5 years managed care operations experience handling independent work with at least one year experience developing and negotiating provider contracts. *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 territory, including overnight stays Preferred Job Qualifications: *Bachelor Degree in Business. #LI-SZ1 #LI-Hybrid 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 ************************************** The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject 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$55,900.00 - $123,500.00 Exact compensation may vary based on skills, experience, and location.