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Member Care Coordinator - Government Programs
HCSC - Lovington, NM
We are the Health Care Management division of HCSC — a team of dedicated nurses, doctors and other clinicians. Everything we do, and every decision we make, aims to help our members live their most healthy lives. We treat the whole person with integrated pharmacy, physical and mental health care benefits. We're also tackling the social determinants of health by crea...
Member Care Coordinator - Government Programs
HCSC - Sante Fe, NM
We are the Health Care Management division of HCSC — a team of dedicated nurses, doctors and other clinicians. Everything we do, and every decision we make, aims to help our members live their most healthy lives. We treat the whole person with integrated pharmacy, physical and mental health care benefits. We're also tackling the social determinants of health by crea...
Medical Reviewer LPN (Remote)
HCSC - Richardson, TX
***This is a work from home position after approx. 3 weeks of training in office, must reside within 75 miles of either Richardson, Texas or Chicago, Illinois office location*** We are the Health Care Management division of HCSC — a team of dedicated nurses, doctors and other clinicians. Everything we do, and every decision we make, aims to help our members live their most healthy li...
Senior Business Solutions Consultant
HCSC - Chicago, IL
At HCSC, building a talent engine for the future is a key priority because we recognize that as our business evolves to reflect the changing world, we must adapt our workforce to meet this challenge. Additionally, with "excellence" as one of our core values, we are focused on improving our success measures and delivering the best possible customer experience. BASIC FU...
Fraud Investigator - Insurance Claims
HCSC - Richardson, TX
BASIC FUNCTION: This position is responsible for planning and developing investigation tools and techniques to conduct detailed investigations of potentially fraudulent claim activity by members, employees and providers, both internally and externally initiated, and makes recommendations for prosecution, recovery and litigation. Also, reviews operational controls, and claim ...
Customer Advocate I
HCSC - Richardson, TX
BASIC FUNCTION: Under supervision, this position is responsible for working on the phone all day in a call center to assist members and physicians by responding to telephone and written inquiries in a prompt, accurate and objective manner. Duties include: conducting research; spends approximately 90% of the scheduled time on the phone according to business need. JOB REQUIREMENTS:...
Customer Advocate I
HCSC - Springfield, IL
BASIC FUNCTION: Under supervision, this position is responsible for working on the phone all day in a call center to assist members and physicians by responding to telephone and written inquiries in a prompt, accurate and objective manner. Duties include: conducting research; spends approximately 90 of the scheduled time on the phone according to business need. JOB REQUIREMENTS:
Production Support & Issue Analyst
HCSC - Chicago, IL
Job Purpose: The Production Support & Issue Analyst is responsible for providing support, triage and resolution of complex system and/or application issues to support Value Based Care program operations. He or she will gather and assess business information needs and results for Value Base Care programs. Central point of contact for production related issues. She or he will interact w...
Staff Accountant (Accountant II)
HCSC - Chicago, IL
(Fin Rptg)This position is responsible for preparing financial reports and statements by performing accounting and analysis at an advanced level, preparing journal entries and account reconciliations. Researching and troubleshooting challenging questions and unusual cases; responding to complex or escalated questions or issues or volatile situations. Preparing reports requiring analysis or e...
Product Architect Consultant (Middleware-WAS)
HCSC - Chicago, IL
As the healthcare industry continues to rapidly transform, our IT team conceives, develops and delivers impactful technology solutions to support access to quality, affordable healthcare for our members. We are driven by our collective company purpose: To do everything in our power to stand with our members in sickness and in health®. Our IT team unleashes the power of this purpose through t...
IT Business Communications Analyst
HCSC - Richardson, TX
As the health care industry continues to rapidly transform, our IT team conceives, develops, and delivers impactful technology solutions to support access to quality, affordable health care for our members. We are driven by our collective company purpose: To do everything in our power to stand with our members in sickness and in health®. Our IT team unleashes the power of this purpose throug...
Senior Actuarial Analyst
HCSC - Richardson, TX
Senior Actuarial Analyst Job Purpose: This position is responsible for participating in implementation, maintenance and more detailed analysis of models, studies and systems which use actuarial principles for the purposes of pricing, underwriting, statistics, reserving, forecasting and other actuarial functions; running and developing complica...
Care Coordinator UM/CM I - Government Programs
HCSC - Downers Grove, IL
We are the Health Care Management division of HCSC — a team of dedicated nurses, doctors and other clinicians. Everything we do, and every decision we make, aims to help our members live their most healthy lives. We treat the whole person with integrated pharmacy, physical and mental health care benefits. We're also tackling the social determinants of health by creating non-clinical ...
Senior Managing Actuary
HCSC - Richardson, TX
Senior Managing Actuary Job Purpose: This position is responsible for managing the implementation, maintenance and critical review and analysis of models, studies and systems which use actuarial principles for the purposes of pricing, underwriting, statistics, reserving, forecasting and other actuarial functions; developing complicated models...
Supplier/Vendor Management Analyst III - IT
HCSC - Chicago, IL
SUMMARY: Member of a high performing team, responsible for executing on supplier management framework, supplier governance solutions for tier 1 suppliers in support of the HCSC business needs. Responsible for fostering relationships (internal and external), and managing performance and issues for a mid-tier list of critical suppliers (Tier 2) from our defined supplier po...
