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Medical Management Trainer

HCSC - Chicago, 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 n...

Health Coordinator - HAS / Chicago (UNION)

HCSC - Chicago, IL

** This position needs to be computable distance from Chicago, IL** Work Schedule ~~ Tues - Fri 9:30am - 6pm / Sat 7:30 am to 3:30 pm BASIC FUNCTION: This position is responsible for contacting members to inform and educate them on our medical management programs; conducting research, performing data entry, responding to inquires from memb...

Health Coordinator - HAS (Richardson, TX)

HCSC - Richardson, TX

** This position needs to be computable distance from Richardson TX ** Work Schedule: Tuesday -Saturday shift 9:30am-6:00pm and Saturday 7:00am-3:30PM. BASIC FUNCTION: This position is responsible for contacting members to inform and educate them on our medical management programs; conducting researc...

BH Clinical Appeals Reviewer

HCSC - Chicago, IL

** This position is Telecommute and needs to be commutable distance from Chicago, IL. ** BASIC FUNCTION: “This positions main responsible will be reviewing records and claims sent by providers and facilities in order to complete Behavioral Health post service clinical reviews.” It is also not limited to coordinating clinical appeals/grievanc...

Sr Anl Sys Pricing

HCSC - Albuquerque, NM

Job Purpose: This position is responsible for system pricing development; support functions needed for contract financial analysis and performance; coordination of internal/external audit requests; performing routine and ad hoc reporting; and maintaining an understanding of provider contracts. Required Job Qualifications: * Bachelor Degree in ...

Sr Anl Sys Pricing

HCSC - Houston, TX

Job Purpose: This position is responsible for system pricing development; support functions needed for contract financial analysis and performance; coordination of internal/external audit requests; performing routine and ad hoc reporting; and maintaining an understanding of provider contracts. Required Job Qualifications: * Bachelor Degree in ...

Sr Anl Sys Pricing

HCSC - Chicago, IL

Job Purpose: This position is responsible for system pricing development; support functions needed for contract financial analysis and performance; coordination of internal/external audit requests; performing routine and ad hoc reporting; and maintaining an understanding of provider contracts. Required Job Qualifications: * Bachelor Degree in ...

Sr Anl Sys Pricing

HCSC - Richardson, TX

Job Purpose: This position is responsible for system pricing development; support functions needed for contract financial analysis and performance; coordination of internal/external audit requests; performing routine and ad hoc reporting; and maintaining an understanding of provider contracts. Required Job Qualifications: * Bachelor Degree in ...

Sr Anl Sys Pricing

HCSC - Tulsa, OK

Job Purpose: This position is responsible for system pricing development; support functions needed for contract financial analysis and performance; coordination of internal/external audit requests; performing routine and ad hoc reporting; and maintaining an understanding of provider contracts. Required Job Qualifications: * Bachelor Degree in ...

Provider Network Consultant

HCSC - Naperville, IL

BASIC FUNCTION: This position is responsible for developing and maintaining cooperative working relationships with the contracting provider community; educating, training, researching problems; and identifying trends and evaluating providers to ensure contractual and financial requirements are adhered to and performed. JOB REQUIREMENTS: * Bachel...

Provider Network Consultant

HCSC - Chicago, IL

BASIC FUNCTION: This position is responsible for developing and maintaining cooperative working relationships with the contracting provider community; educating, training, researching problems; and identifying trends and evaluating providers to ensure contractual and financial requirements are adhered to and performed. JOB REQUIREMENTS: * Bachel...

Medicare Operations Specialist

HCSC - Lacy Lakeview, TX

BASIC FUNCTION: This position is responsible for project leadership and coordination of the Medicaid and Medicare managed care regulations and program changes supporting Health Care Service Corporation Dual Eligible Program. Operations Specialist works with other areas of the organization on the development, testing and implementation of program policies, business pro...

Medicare Operations Specialist

HCSC - San Miguel County, NM

BASIC FUNCTION: This position is responsible for project leadership and coordination of the Medicaid and Medicare managed care regulations and program changes supporting Health Care Service Corporation Dual Eligible Program. Operations Specialist works with other areas of the organization on the development, testing and implementation of program policies, business pro...

Medicare Operations Specialist

HCSC - Lombard, IL

BASIC FUNCTION: This position is responsible for project leadership and coordination of the Medicaid and Medicare managed care regulations and program changes supporting Health Care Service Corporation Dual Eligible Program. Operations Specialist works with other areas of the organization on the development, testing and implementation of program policies, business pro...

Medicare Operations Specialist

HCSC - Lawton, OK

BASIC FUNCTION: This position is responsible for project leadership and coordination of the Medicaid and Medicare managed care regulations and program changes supporting Health Care Service Corporation Dual Eligible Program. Operations Specialist works with other areas of the organization on the development, testing and implementation of program policies, business pro...