Sr. Manager Payment Integrity Strategy and Operations

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.

Job Summary

This Position Is Responsible For Leading The Process Leaders/Process Stewards In Planning, Defining, Developing, Testing, Documenting, Analyzing Results And/Or Implementing Process Improvement And Process Reengineering Opportunities. Leading And Supporting Business Process Activities And Methods To The Super Process Leaders/Process Steward. Leading Team Activities, Deliverables, And Issue Resolution. Leading Key Activities Including Data Collection, Metric Definition And Analysis, And Root Cause Analysis. Supporting Development And Evolution Of Hcsc Business Process Management Methodology Identifying Best Practice Standards, Guidelines, Procedures And Tools For Analyzing, Designing, And Implementing Business Process Initiatives. Ability To Travel.

Job Requirements:

• Bachelor’s degree and 8 years of experience in health care quality improvement, health care accreditation, health care operations, or combination thereof OR 12 years of experience in health care quality improvement, health care accreditation, health care operations, or combination thereof, including 8 years of experience in the health insurance industry with large, multi-state payer(s).
• 3 years of leadership or management experience.
• Experience with Continuous Quality Improvement (CQI) concepts, Strategy, and Change Management concepts.
• Experience with external accrediting agency requirements (i.e., NCQA, URAC, AAAHC) and history of success in achieving accreditation.
• Experience providing support to senior-level staff in process re-engineering and strategic problem-solving.
• Analytical skills and negotiation skills.
• Verbal and written communication skills including leadership skills, organizational skills and detail-orientation, interpersonal skills, consensus building skills, professional presentation skills and decision-making skills.
• Experience preparing documentation for auditors or project management
• Knowledge and understanding of the health care industry and regulatory requirements.
• Experience writing policies and procedures.
• Written and verbal communication skills.
• Ability and willingness to occasional travel.

Preferred Job Requirements:

• Payment integrity operational processes and strategy

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

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.

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.

Base Pay Range$102,000.00 - $184,300.00

Exact compensation may vary based on skills, experience, and location.