Health Care Service Corporation

Behavioral Health Care Coord

Health Care Service Corporation · Full Time · 5 hours ago

Health Care Service Corporation

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

This position is responsible for conducting accurate and timely clinical reviews of behavioral health cases to determine medical necessity. The role involves interpreting contracts, reviewing medical records, and assisting members via telephone.

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Principal, Risk Adjustment Analytics Consultant - REMOTE

Health Care Service Corporation · Full Time · 2 days ago

Health Care Service Corporation

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

The Principal Risk Adjustment Consultant drives analytical strategies and solutions to optimize Medicare Risk Adjustment performance. This role delivers actionable insights, builds dynamic visualizations, and provides strategic advisory services to internal stakeholders and senior leadership.

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Sr Developer - React Native

Health Care Service Corporation · Full Time · 2 days ago

Health Care Service Corporation

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

You will be responsible for building and maintaining high-quality cross-platform mobile applications for iOS and Android while collaborating with cross-functional teams. Additionally, you will provide technical leadership and mentor other developers to promote best practices and professional growth.

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Mgr Financial Planning & Analysis

Health Care Service Corporation · Full Time · 2 days ago

Health Care Service Corporation

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

The Manager of FP&A will lead financial planning, forecasting, and reporting to support the company's strategic business objectives. This role involves managing value-based care contract modeling and collaborating with executive leadership to drive financial performance and process improvements.

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Government Programs Care Manager III - 743

Health Care Service Corporation · Full Time · 2 days ago

Health Care Service Corporation

🌎 United States 💵 $34.9 - $57.89 per hour ⭐ 2-5 yrs exp 💼 Healthcare

This role involves providing telephonic and field-based care coordination to members to address their personal health needs and goals. The manager will conduct health screenings, comprehensive assessments, and care planning for complex and specialty populations.

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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

The Clinical Pharmacist conducts comprehensive medication reviews for high-risk Medicare members to improve drug therapy safety and effectiveness. They collaborate with a multidisciplinary team to address medication adherence, drug interactions, and evidence-based gaps in care.

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Network Development Spec

Health Care Service Corporation · Full Time · 3 days ago

Health Care Service Corporation

🌎 United States 💵 $55900 - $123K per year ⭐ 2-5 yrs exp 💼 Others

The Network Development Specialist is responsible for contracting with dentists through telemarketing to achieve network growth goals. They manage the full cycle of outreach, negotiation, and relationship development before transitioning the account to other departments.

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Staff Accountant

Health Care Service Corporation · Full Time · 3 days ago

Health Care Service Corporation

🌎 United States 💵 $51400 - $92800 per year ⭐ 2-5 yrs exp 💼 Finance

This position is responsible for treasury and accounts receivable functions, including the reconciliation of accounting records. Additionally, the role supports the annual audit and identifies opportunities for process improvements.

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Sr Claims Analyst - LHB

Health Care Service Corporation · Full Time · 3 days ago

Health Care Service Corporation

🌎 United States 💵 $18.07 - $33.92 per hour ⭐ 2-5 yrs exp 💼 Finance

The Senior Claims Analyst is responsible for the accurate adjudication and processing of medical, dental, and disability claims in accordance with plan documents and legal regulations. They also serve as a liaison for internal departments and provide guidance to team members regarding claim processing procedures.

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Government Account Rep

Health Care Service Corporation · Full Time · 3 days ago

Health Care Service Corporation

🌎 United States 💵 $54500 - $81900 per year ⭐ 2-5 yrs exp 💼 Others

The role involves managing government accounts by promoting enrollment growth and providing service to federal employees through presentations and educational seminars. The representative acts as a liaison between members, federal agencies, and the company to resolve claims and enrollment issues.

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Resource Mgmt Analyst

Health Care Service Corporation · Full Time · 3 days ago

Health Care Service Corporation

🌎 United States 💵 $41700 - $92800 per year ⭐ 2-5 yrs exp 💼 Others

The analyst is responsible for managing real-time workforce operations, including monitoring SLAs, productivity, and inventory levels for front or back-office functions. They will also analyze data to recommend process improvements and prepare strategic reporting for executive and managerial partners.

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Claims Analyst - LHB

Health Care Service Corporation · Full Time · 4 days ago

Health Care Service Corporation

🌎 United States 💵 $14.97 - $28.12 per hour ⭐ 0-2 yrs exp 💼 Finance

The Claims Analyst is responsible for the accurate adjudication and processing of medical, dental, or disability claims according to plan documents and established guidelines. They must calculate benefit payments, communicate claim decisions, and provide responsive customer service while managing assigned workloads.

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Behavioral Health Care Management Specialist - 743

Health Care Service Corporation · Full Time · 4 days ago

Health Care Service Corporation

🌎 United States 💵 $34.9 - $57.89 per hour ⭐ 2-5 yrs exp 💼 Healthcare

This position is responsible for conducting care management and health education programs for customers on government health care programs. Accountabilities include gathering, analyzing, and providing data for regulatory reports while representing the company to members.

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Senior Network Development Specialist

Health Care Service Corporation · Full Time · 5 days 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 initial relationship development, and perform financial negotiations with dental providers.

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Systems Specialist-Remote

Health Care Service Corporation · Full Time · 5 days ago

Health Care Service Corporation

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

This role is responsible for developing, supporting, and maintaining automation solutions using UiPath and Azure AI platforms. The specialist will collaborate with stakeholders to translate business requirements into scalable, high-quality technical solutions.

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Delegation Oversight Coordinator - Work From Home

Health Care Service Corporation · Full Time · 6 days ago

Health Care Service Corporation

🌎 United States 💵 $55900 - $123K per year ⭐ 5-10 yrs exp 💼 Others

The coordinator is responsible for monitoring and evaluating activities delegated to vendors and contracted entities to ensure compliance with regulatory and accreditation standards. They also perform financial accuracy audits and monitor claims processing, payment accuracy, and denial ratios.

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Customer Advocate I

Health Care Service Corporation · Full Time · 6 days ago

Health Care Service Corporation

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

The Customer Advocate assists members and physicians by responding to telephone and written inquiries in a prompt and accurate manner. The role involves conducting research and spending approximately 85-90% of scheduled time on the phone.

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Network Management Consultant - Work From Home

Health Care Service Corporation · Full Time · 6 days ago

Health Care Service Corporation

🌎 United States 💵 $55900 - $123K per year ⭐ 2-5 yrs exp 💼 Others

This position is responsible for maintaining strong relationships with the provider community through recruiting, contracting, and risk management. The role involves negotiating small to mid-size contracts for hospitals and physician groups while supporting complex contracting activities.

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Mgr HR Regulatory Compliance (Remote)

Health Care Service Corporation · Full Time · 6 days ago

Health Care Service Corporation

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

This position manages employment practices, policies, and regulatory compliance, including the Affirmative Action Program and immigration processes. The role involves consulting on federal and state employment laws while partnering with legal and corporate compliance teams to resolve issues.

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Sr Network Mgmt Consultant

Health Care Service Corporation · Full Time · 7 days ago

Health Care Service Corporation

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

Responsible for recruiting and contracting small to mid-size providers, including physicians and facilities. Develops and negotiates contracts while maintaining strategic provider relationships within an assigned territory.

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Senior Crisis Management Consultant

Health Care Service Corporation · Full Time · 7 days ago

Health Care Service Corporation

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

Responsible for identifying and triaging events to reduce business impact and coordinating enterprise-wide responses to business interruptions. Duties include serving as a Duty Officer, managing mass notifications, and maintaining crisis management software tools.

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Head of Group Retirement Sales

Health Care Service Corporation · Full Time · 8 days ago

Health Care Service Corporation

🌎 United States 💵 $153K - $229K per year ⭐ 10+ yrs exp 💼 Sales

The Head of Group Retiree Sales is responsible for driving revenue growth and market share in the Medicare retirement space through strategic go-to-market planning. This role involves leading a team of sales professionals and collaborating with product and compliance teams to deliver solutions to large employers.

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Product Development Manager

Health Care Service Corporation · Full Time · 10 days ago

Health Care Service Corporation

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

Responsible for the end-to-end delivery of strategic IT and HR projects, including managing budgets, schedules, and resources. The role involves establishing governance frameworks, standardizing processes, and mentoring project managers to align portfolios with business objectives.

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Network Management Consultant - Work From Home

Health Care Service Corporation · Full Time · 10 days ago

Health Care Service Corporation

🌎 United States 💵 $55900 - $123K per year ⭐ 2-5 yrs exp 💼 Others

The role supports provider recruitment and contracting to ensure strategic coverage for Texas Territory across Commercial, IFM, and Government Programs. Responsibilities include negotiating contracts for hospitals and physicians and maintaining provider relationships.

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Sr. Analyst System Pricing - Work From Home

Health Care Service Corporation · Full Time · 13 days ago

Health Care Service Corporation

🌎 United States 💵 $61500 - $136K per year ⭐ 5-10 yrs exp 💼 Others

Responsible for system pricing development and providing support for contract financial analysis and performance. This includes coordinating audit requests, performing routine and ad hoc reporting, and maintaining provider contract knowledge.

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Customer Advocate I

Health Care Service Corporation · Full Time · 13 days ago

Health Care Service Corporation

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

Provide assistance to providers and Indian Health Services regarding claims, pricing, and coordination of benefits. Act as a liaison between providers and IHS while recommending process improvements and supporting project testing.

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Senior Workforce Planning Analyst - HealthSpring

Health Care Service Corporation · Full Time · 14 days ago

Health Care Service Corporation

🌎 United States 💵 $55900 - $123K per year ⭐ 2-5 yrs exp 💼 Recruitment

The role supports workforce management and operational planning for customer service operations, focusing on budgeting, forecasting, and capacity planning. It involves monitoring real-time performance, optimizing resource utilization, and coordinating off-phone activities to ensure service excellence.

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Healthcare Sr Analytics Consultant - Medicare Part D Stars

Health Care Service Corporation · Full Time · 17 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 advanced reporting and dashboards to support critical business decisions regarding clinical, administrative, and customer experience measures.

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Customer Service Representative - LHB

Health Care Service Corporation · Full Time · 17 days ago

Health Care Service Corporation

🌎 United States 💵 $20 - $22 per hour ⭐ 2-5 yrs exp 💼 Support

Respond to high-volume telephonic and electronic inquiries regarding benefits, eligibility, and claim status. Accurately document all actions and navigate multiple system applications to resolve customer issues.

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Resource Management Analyst

Health Care Service Corporation · Full Time · 17 days ago

Health Care Service Corporation

🌎 United States 💵 $41700 - $92800 per year ⭐ 2-5 yrs exp 💼 Others

Manage workforce management for back office functions to optimize operational activity. Analyze reporting to improve caller experience, work queue management, and staff performance.

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Customer Service Supervisor

Health Care Service Corporation · Full Time · 19 days ago

Health Care Service Corporation

🌎 United States 💵 $42200 - $79300 per year ⭐ 5-10 yrs exp 💼 Support

Supervise and manage a remote team of inbound and outbound customer service representatives to ensure exceptional service delivery. Responsible for meeting client service expectations, achieving service objectives, and fostering staff development.

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Supervisor Customer Service - LHB

Health Care Service Corporation · Full Time · 19 days ago

Health Care Service Corporation

🌎 United States 💵 $42200 - $79300 per year ⭐ 5-10 yrs exp 💼 Support

Supervise and manage a remote team of inbound and outbound customer service representatives to deliver exceptional service. Ensure the achievement of client service expectations, health benefits objectives, and staff development.

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Benefit Advocate

Health Care Service Corporation · Full Time · 24 days ago

Health Care Service Corporation

🌎 United States 💵 $14.97 - $28.12 per hour ⭐ 0-2 yrs exp 💼 Others

Manage and coordinate a high volume of service requests via phone, email, portal, and chat for client employees and their families. Educate callers on navigating and maximizing the value of their healthcare benefits and incentive programs.

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Sr Staff Actuary - remote

Health Care Service Corporation · Full Time · a month ago

Health Care Service Corporation

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

Manage the implementation and analysis of actuarial models for pricing, reserving, and forecasting. Develop complex models and lead projects across various departments to drive informed decision-making.

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Sr Actuarial Analyst - remote

Health Care Service Corporation · Full Time · a month ago

Health Care Service Corporation

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

The role involves implementing and maintaining actuarial models and systems for pricing, reserving, and forecasting. It also requires performing detailed analysis of results and creating presentations to support business decision-making.

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Lead Data Science Engineer

Health Care Service Corporation · Full Time · a month ago

Health Care Service Corporation

🌎 United States 💵 $121K - $225K per year ⭐ 5-10 yrs exp 💼 Software Development

Responsible for engineering AI capabilities for the Intelligent Delivery Platform, including data pipeline creation and optimization. This includes managing AI models through MLOps, implementing RAG systems, and performing prompt engineering.

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Medical Director

Health Care Service Corporation · Full Time · 2 months 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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Sr Sales Executive

Health Care Service Corporation · Full Time · 2 months 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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Regional Medical Director

Health Care Service Corporation · Full Time · 3 months 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 · 3 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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