Health Care Service Corporation

Sr Infrastructure Engineer - Cribl

Health Care Service Corporation · Full Time · 13 hours ago

Health Care Service Corporation

🌎 United States 💵 $84400 - $152K per year ⭐ 5-10 yrs exp 💼 Software Development

Design, implement, and optimize data pipelines using Cribl Stream and Edge for observability and security platforms. Provide 24x7 operational support, including monitoring and resolving data ingestion and routing issues.

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Customer Advocate I

Health Care Service Corporation · Full Time · a day ago

Health Care Service Corporation

🌎 United States 💵 $17.75 - $28.39 per hour ⭐ 0-2 yrs exp 💼 Support

This role involves handling high-volume telephone and written inquiries from members and physicians in a call center environment. The employee will conduct research and spend approximately 85-90% of their time on the phone providing prompt and accurate assistance.

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Executive Director, Payment Transformation (Work from home)

Health Care Service Corporation · Full Time · a day ago

Health Care Service Corporation

🌎 United States 💵 $161K - $299K per year ⭐ 10+ yrs exp 💼 Others

Oversee enterprise payment transformation and Value Based Care (VBC) strategies, including model design and end-to-end administration. Lead cross-functional teams in managing provider contracting, payment platforms, and analytics for over $2B in annual provider payments.

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Senior Application Architect-Azure

Health Care Service Corporation · Full Time · a day ago

Health Care Service Corporation

🌎 United States 💵 $112K - $202K per year ⭐ 5-10 yrs exp 💼 Software Development

Design, implement, and optimize data platforms built on Databricks to ensure performance and scalability of data pipelines. Manage Databricks workspaces and clusters while integrating them with cloud platforms and implementing security controls.

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Sr. Manager Key Provider Contracts - Work From Home

Health Care Service Corporation · Full Time · a day ago

Health Care Service Corporation

🌎 United States 💵 $102K - $184K per year ⭐ 10+ yrs exp 💼 Others

Directs negotiations and execution of business plans for high-value provider partners to support long-term market objectives. Manages financial and operational engagement strategies across various healthcare programs and non-standard arrangements.

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Senior Application Architect-Databrick

Health Care Service Corporation · Full Time · a day ago

Health Care Service Corporation

🌎 United States 💵 $112K - $202K per year ⭐ 5-10 yrs exp 💼 Software Development

Design, implement, and optimize data platforms built on Databricks to manage large-scale data processing systems. Ensure the performance, reliability, and scalability of data pipelines to enable advanced analytics and machine learning workloads.

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Clinical Pharmacist (MTM) - Work From Home

Health Care Service Corporation · Full Time · 3 days ago

Health Care Service Corporation

🌎 United States 💵 $102K - $184K per year ⭐ 2-5 yrs exp 💼 Healthcare

Conduct comprehensive medication reviews for high-risk Medicare members to improve drug therapy safety and effectiveness. Collaborate with multidisciplinary teams to address gaps in care and support STAR-related pharmacy initiatives.

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Mgr Financial Planning & Analysis

Health Care Service Corporation · Full Time · 4 days ago

Health Care Service Corporation

🌎 United States 💵 $102K - $184K per year ⭐ 5-10 yrs exp 💼 Finance

The Manager of FP&A supports financial and business objectives through strategic planning, forecasting, and reporting. Key duties include managing VBC contract performance, long-range planning, and supporting financial system implementations.

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Medical Director

Health Care Service Corporation · Full Time · 5 days ago

Health Care Service Corporation

🌎 United States 💵 $191K - $355K per year ⭐ 5-10 yrs exp 💼 Healthcare

The Medical Director is responsible for managing assigned medical policies and programs. This includes performing medical reviews and interacting with provider communities.

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Medical Director

Health Care Service Corporation · Full Time · 5 days ago

Health Care Service Corporation

🌎 United States 💵 $191K - $355K per year ⭐ 5-10 yrs exp 💼 Healthcare

Responsible for managing assigned medical policies and programs. Performs medical reviews and collaborates with provider communities.

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Sales (IC) Senior Manager - Broker Strategy & Virtual Broker Sales - Work From Home

Health Care Service Corporation · Full Time · 6 days ago

Health Care Service Corporation

🌎 United States 💵 $119K - $179K per year ⭐ 5-10 yrs exp 💼 Sales

Drive the Local Broker Strategy and manage a virtual sales team focused on Individual Medicare Advantage and Part D sales. Act as a conduit between national and local broker teams to ensure effective communication and a best-in-class broker experience.

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Principal Network Management Consultant (Work From Home) - Hospital Contracting

Health Care Service Corporation · Full Time · 6 days ago

Health Care Service Corporation

🌎 United States 💵 $92700 - $167K per year ⭐ 5-10 yrs exp 💼 Teaching

Responsible for recruiting and negotiating contracts with large independent and integrated hospital systems. Focuses on maintaining provider relationships and ensuring strategic coverage within the assigned territory.

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Claim Technician

Health Care Service Corporation · Full Time · 7 days ago

Health Care Service Corporation

🌎 United States 💵 $17.75 - $26.17 per hour ⭐ 2-5 yrs exp 💼 Others

Responsible for processing complex medical claims that require detailed investigation. This includes resolving pended claims and managing the coordination of benefits.

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Primary Nurse Case Admin 1 - Work From Home

Health Care Service Corporation · Full Time · 8 days ago

Health Care Service Corporation

🌎 United States 💵 $61500 - $136K per year ⭐ 2-5 yrs exp 💼 Healthcare

The Primary Nurse Coordinator manages utilization, case, and disease management functions to serve as a single point of contact for members and providers. Responsibilities include performing concurrent reviews, discharge planning, and facilitating care coordination to ensure cost-effective health outcomes.

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Manager - Provider Contracting - Work From Home

Health Care Service Corporation · Full Time · 9 days ago

Health Care Service Corporation

🌎 United States 💵 $92700 - $167K per year ⭐ 5-10 yrs exp 💼 Others

Responsible for managing provider agreement negotiations and maintaining harmonious relationships with assigned providers. The role also involves managing staff through hiring, training, performance reviews, and budget administration.

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Market Medical Director (Alabama)

Health Care Service Corporation · Full Time · 11 days ago

Health Care Service Corporation

🌎 United States 💵 $191K - $355K per year ⭐ 5-10 yrs exp 💼 Healthcare

The Market Medical Director drives strategy and clinical excellence in clinical programs, Stars, and risk adjustment to optimize the total cost of care. They are responsible for strengthening partnerships with providers, health systems, and managed service organizations to ensure positive customer outcomes.

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Quality Management Specialist II

Health Care Service Corporation · Full Time · 12 days ago

Health Care Service Corporation

🌎 United States 💵 $61500 - $136K per year ⭐ 2-5 yrs exp 💼 Others

Facilitate clinical quality improvement projects and evaluate compliance with clinical practice guidelines for providers and IPAs. Consult with physicians and members to implement and monitor services that meet quality project objectives.

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Independent Dispute Resolution Rep

Health Care Service Corporation · Full Time · 12 days ago

Health Care Service Corporation

🌎 United States 💵 $17.75 - $28.39 per hour ⭐ 2-5 yrs exp 💼 Others

Responsible for the intake, processing, and coordination of materials related to negotiations and independent disputes regulated by federal and state laws. The role involves accurately responding to provider resolutions and entering new requests into the appropriate database.

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Sr Sales Executive

Health Care Service Corporation · Full Time · 12 days ago

Health Care Service Corporation

🌎 United States 💵 $73500 - $110K per year ⭐ 5-10 yrs exp 💼 Sales

Accountable for delivering sales results for health, life, and ancillary insurance products in the Southern Illinois and St. Louis territory. Focuses on building and expanding key broker relationships and identifying territory-specific growth opportunities.

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Principal, Risk Adjustment Analytics Consultant - REMOTE

Health Care Service Corporation · Full Time · 14 days ago

Health Care Service Corporation

🌎 United States 💵 $102K - $184K per year ⭐ 10+ yrs exp 💼 Software Development

Drive analytical strategies to optimize Medicare Risk Adjustment performance and deliver actionable insights to senior leadership. Responsibilities include revenue optimization, risk forecasting, and translating technical coding and regulatory nuances into business recommendations.

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Clinical Practice Consultant - Work From Home

Health Care Service Corporation · Full Time · 15 days ago

Health Care Service Corporation

🌎 United States 💵 $70600 - $149K per year ⭐ 5-10 yrs exp 💼 Healthcare

This role supports quality imperatives and value-based care models by collaborating with medical practices to improve HEDIS measures. Responsibilities include conducting clinical readiness assessments, implementing member outreach, and maintaining relationships with care management teams.

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Healthcare Sr Analytics Consultant - Medicare Part D Stars

Health Care Service Corporation · Full Time · 18 days ago

Health Care Service Corporation

🌎 United States 💵 $84400 - $152K per year ⭐ 5-10 yrs exp 💼 Software Development

Lead the development of technical and analytical enhancements to improve Medicare Part D Star ratings. Design and develop advanced reporting and dashboards to support critical business decisions regarding clinical and customer experience measures.

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Systems Specialist-Remote

Health Care Service Corporation · Full Time · 18 days ago

Health Care Service Corporation

🌎 United States 💵 $102K - $184K per year ⭐ 5-10 yrs exp 💼 Others

Develop, support, and maintain intelligent automations using UiPath and Azure AI/Foundry platforms. Serve as a technical lead to translate business requirements into scalable, high-quality automation solutions.

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TRS Account Manager

Health Care Service Corporation · Full Time · 19 days ago

Health Care Service Corporation

🌎 United States 💵 $66400 - $99600 per year ⭐ 2-5 yrs exp 💼 Sales

Responsible for providing on-site and territorial support to assigned accounts to retain membership and grow the business. This includes implementing healthcare activities, conducting training and enrollment sessions, and ensuring overall client satisfaction.

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Manager, Medicare Risk Adjustment Analytics Consulting - REMOTE

Health Care Service Corporation · Full Time · 20 days ago

Health Care Service Corporation

🌎 United States 💵 $112K - $202K per year ⭐ 5-10 yrs exp 💼 Software Development

Drive revenue integrity and analytics strategy by serving as a primary consultative resource for strategic Medicare Risk Adjustment initiatives. Lead cross-functional teams to transform complex financial data into actionable business intelligence and predictive models.

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Market Medical Director

Health Care Service Corporation · Full Time · a month ago

Health Care Service Corporation

🌎 United States 💵 $191K - $355K per year ⭐ 5-10 yrs exp 💼 Healthcare

The Market Medical Director drives strategy and clinical excellence in clinical programs, Stars, and risk adjustment to optimize the total cost of care. They are responsible for strengthening partnerships with providers, health systems, and managed service organizations to ensure positive customer outcomes.

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Medical Director

Health Care Service Corporation · Full Time · a month ago

Health Care Service Corporation

🌎 United States 💵 $191K - $355K per year ⭐ 5-10 yrs exp 💼 Healthcare

The Medical Director will collaborate with leadership to improve underwriting tools, clinical reviews, and processes. They will leverage clinical expertise to deploy innovations and deliver market-leading strategies for supplemental benefits.

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Regional Medical Director

Health Care Service Corporation · Full Time · a month ago

Health Care Service Corporation

🌎 United States 💵 $191K - $355K per year ⭐ 5-10 yrs exp 💼 Healthcare

Responsible for managing medical policies and programs while providing clinical leadership across medical management and population health initiatives. The role focuses on influencing quality, affordability, and risk adjustment accuracy through strategic provider-performance initiatives.

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Sr Network Development Spec

Health Care Service Corporation · Full Time · 2 months ago

Health Care Service Corporation

🌎 United States 💵 $61500 - $136K per year ⭐ 10+ yrs exp 💼 Others

The role involves managing complex contracting for dentists within an assigned territory to achieve annual network growth goals. Responsibilities include conducting outreach, cold calls, and relationship development to successfully contract dental locations.

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Senior Network Development Specialist

Health Care Service Corporation · Full Time · 2 months ago

Health Care Service Corporation

🌎 United States 💵 $61500 - $136K per year ⭐ 10+ yrs exp 💼 Others

The specialist is responsible for complex contracting of dentists within an assigned territory to achieve annual network growth goals. They will conduct outreach, manage financial negotiations, and foster initial relationships with new dental providers.

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Sales (IC) Lead Associate - Broker Sales

Health Care Service Corporation · Full Time · 4 months ago

Health Care Service Corporation

🌎 United States 💵 $77400 - $116K per year ⭐ 5-10 yrs exp 💼 Sales

This role is responsible for executing the Healthspring strategy across local topline sales agencies, directly contracted agents, and broker down-line sales within the managed market. Key activities include training, relationship management, member retention, and driving overall sales growth.

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