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 Analyzing The Complex Business Problems Being Addressed By Product, Member, Provider, Regulatory And Enterprise Strategies, And New Business Cases And Developing Solutions For Clients. Analyzes Complex Business Problems And Issues Using Data From Internal And External Sources To Provide Insight To Decision-Makers. Defines Client Needs, Determines A Strategy And Develops A Plan/Proposal For Delivery Of The Project. May Provide Consultation To Clients And Lead Cross-Functional Teams To Address Business Issues. May Directly Produce Datasets And Reports For Analysis Using System Reporting Tools. The Person In This Position May Also Be Responsible For Writing Business Cases For New Information-Based Solutions And Should Know How To Equate Business Outcomes With Cost Benefit Analysis And Tangible Metrics To Support.

NOTE:  This hybrid role is located in NASHVILLE, TN ~ relocation will not be offered; sponsorship is not available.

Required Job Qualifications:  
* Bachelor’s degree and 5 years of experience OR 9 years of experience in business testing, business analysis, process improvement, project management, business operations or relevant health care industry experience
* 3 years of experience leading with large and complex multi-million-dollar projects.
* Experience communicating with senior management from multiple divisions. 
* Experience developing and delivering presentations. 
* Problem resolution experience and skills. 
* Knowledge of strategic planning techniques and industry trends
* Experience interpreting business and financial information
* Negotiations skills. 
* Verbal and written communications skills including establishing working relationships across departments, preparing presentations to senior management, and establishing team environment. 
* Organizational skills. 
* Experience managing multiple complex projects successfully. 
* Detail oriented. 
* PC proficiency to include MS Office products

* Knowledge and/or experience with:

•        · Medicare Part A/B/D

•        · Provider workflows & Provider application - Symplr

•        · EDI formats – 837 I&P, 276/277, 270/271, 278, 834

•        · Member Enrollment – Elements application

•        · Member Collaterals

•        · Provider Credentialing – sCRED application

•        · Claims Intake process

•        · Claims Adjudication logic – FACETS application

•        · EOB

•        · Provider Payments – 835 remittance files & EOP

•        · CMS reporting

•        · SalesForce

•        · Evolve/Broker

* Test case management tools such as Zephyr

* Agile tool such as Jira/Rally

* SQL

* Health insurance or healthcare industry experience with emphasis on Product/Sales knowledge
 

Preferred Required Job Qualifications:
* Proven strategic thinking and execution
* Ability to drive decisions, create optionality and determine impacts of options

#LI-BS1

#LI-Hybrid

#INCR

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