About this role
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.
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Job Summary
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This position is responsible for the contracting, credentialing, and maintenance of professional provider data to support marketing, membership, and network contracting across all lines of business. This includes providing accurate and timely administration of provider contracts, rosters, provider inquiries, and requests while supporting quality initiatives to ensure data accuracy. Responsibilities include managing high-volume provider communications through email and phone, utilizing Salesforce for case management and documentation, participating in internal provider meetings and work groups, and researching issues related to provider credentialing, claims escalations, provider data, and network participation. The role also includes working as a liaison between Network Contracting, Provider Data Management, and providers to support credentialing, network activities, provider outreach, and operational initiatives while maintaining a large caseload and ensuring timely resolution of provider issues.
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Required Job Qualifications:
- Bachelor’s degree AND 2 years managed care operations experience handling independent work, OR 6 years of relevant experience.
- Ability to work in office in Helena Montana.
Preferred Job Qualifications
- 2 years' experience managing a high volume of provider inquiries and issue resolution through email and phone communication.
- 2 years' proven proficiency with Salesforce for case management, documentation, and provider correspondence.
- Advanced Microsoft Office skills, particularly Outlook, Excel, Word, and Teams, with the ability to create professional written communications.
- Experience drafting and sending clear, professional email communications to providers and external stakeholders.
- Ability to manage a large caseload simultaneously (90+ open cases) while meeting deadlines and maintaining attention to detail.
- Experience in resolving provider claims issues and escalations that could not be resolved through standard customer service channels.
- Strong organizational and time management skills with the ability to prioritize competing responsibilities.
#LI- Hybrid
#LI-KW1
#INAK
Sponsorship is not available
This is FLEX role that requires 3 days in the Helena Montana Office and 2 days remote
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Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
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Pay Transparency Statement:
At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards .
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
Flex employees are expected to be in the office a minimum of three days a week. Management will have discretion to modify an employee's weekly schedule for exigent circumstances.
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. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.
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# Base Pay Range
$47,500.00 - $86,000.00
Exact compensation may vary based on skills, experience, and location.