Jobs at Health Care Service Corporation

Leads complex mergers, acquisitions, integrations, separations, divestitures, carve-outs, partnerships, and vendor initiatives across the transition lifecycle. Develops integration strategies, governance frameworks, operating models, roadmaps, and execution plans; manages stakeholders, risks, dependencies, organizational readiness, KPIs, synergies, and value realization. Advises executives, drives cross-functional alignment, resolves issues, advances integration standards, and mentors team members in a matrixed environment.

Provides white-glove IT support to executive leadership, resolving complex hardware, software, network, and configuration issues. Supports executive offices, leadership meetings, board meetings, corporate events, audiovisual systems, streaming, collaboration, and video conferencing. Coordinates with IT teams, stakeholders, and vendors to resolve incidents rapidly. Plans, tests, monitors, and troubleshoots technology before, during, and after high-profile events while introducing new capabilities and improving service quality through analytics.

Manage and provide technical expertise for federal, state, and local tax filings, income tax accruals, provisions, and financial reporting disclosures. Support tax leadership with technical research, forecasting, compliance and accounting analytics, management reporting, special projects, and process automation. Lead cross-functional projects, resolve tax issues, prepare documentation, facilitate training, and contribute to tax matters involving insurance, investments, mergers, and acquisitions.

Leads software engineering projects and helps align technical resources, product needs, and business objectives. The role requires knowledge of engineering skill sets, software platforms, cloud and SaaS technologies, Agile/Scrum development, resource planning, forecasting, and stakeholder management. Responsibilities also include prioritizing initiatives, explaining technical issues in business terms, supporting strategic planning, developing engineering teams, optimizing vendor resources, and managing technology delivery engagements.

Leads healthcare fraud investigations across Texas, Oklahoma, and New Mexico, oversees an enterprise intelligence unit, and pursues criminal prosecution of fraud cases. Serves as liaison to the FBI, HHS, and other law enforcement agencies while partnering with Legal, Medical, and Network departments. Oversees SID audit and compliance activities, budget development, financial management, and strategic business cases. Manages the department and supports complex civil and criminal investigations.

Ensures project designs align with application architecture roadmaps, supports functional and technical design, defines integrations among applications, databases, and middleware, and serves as a subject matter expert for integrated products. The role requires solution architecture, application development and configuration, cloud computing, DevOps, integration technologies, agile delivery, prototyping, analytical problem-solving, and collaboration.

Processes and adjudicates medical, dental, vision, life, and disability claims according to plan documents, policies, and applicable laws. Investigates claims, determines benefit eligibility, calculates payments, communicates claim decisions, handles correspondence and inquiries, and supports claim teams and vendors. Advises team members on procedures, analyzes plan documents, resolves complex issues, and delivers responsive customer service while meeting production and turnaround-time requirements.

Own and manage BI solution products by translating customer needs into technical requirements, prioritizing development, coordinating stakeholders, promoting adoption, and ensuring successful delivery. The role involves analyzing business problems, creating actionable BI solutions, presenting to varied organizational levels, and potentially supporting BI development and data engineering. It may also indirectly lead analytics consultants and data engineers.

Processes and adjudicates medical, dental, vision, life, disability, and related insurance claims accurately and within established turnaround times. Reviews plan documents and claim guidelines, handles correspondence and electronic inquiries, investigates claims, makes decisions, communicates with members, providers, and clients, and manages multiple tasks in a fast-paced, customer-focused environment. Uses Microsoft Office and proprietary systems while supporting process improvement and collaborative team operations.

Leads and controls financial reporting and analysis while developing HCSC’s financial reporting strategy. Advises senior management on financial accounting, reporting, and analysis. The role supervises and develops employees, manages performance and hiring, coordinates projects across the organization, and presents financial information. It requires strong analytical, communication, organizational, and project management skills, with preferred experience in CPA certification and insurance statutory accounting and reporting.

Provides service to Service Benefit Plan subscribers, promotes enrollment growth among active and retired federal employees, and acts as a liaison between members, federal agencies, and HCSC. The role requires travel, including overnight stays, and uses a company-leased car. Responsibilities involve insurance account servicing, marketing, sales, and customer relationship management within an assigned territory.

Develops, writes, edits, and executes member and benefits communications across email, websites, digital and print materials, newsletters, presentations, and enrollment resources. Partners with marketing, digital, business teams, and client stakeholders to translate complex healthcare information into clear, engaging content. Manages multiple projects, ensures accuracy and timeliness, and supports member understanding and action.

Reviews and verifies billing setups, processes billing and settlement statements, applies adjustments, balances accounts, tracks payments, prepares journal entries, and addresses delinquencies. The role also reviews self-billed group payments, resolves membership mismatches, clears exception reports, processes renewals and terminations, documents procedures, and supports accounting requirements for complex accounts.

Manages the implementation, maintenance, review, and analysis of actuarial models, studies, and systems supporting pricing, underwriting, reserving, forecasting, and statistics. Develops complex models, trains colleagues, prepares presentations and documentation for decision-making, and leads projects involving actuarial and non-actuarial teams. Requires deep expertise in an actuarial area or business segment, with health insurance experience and professional actuarial credentials.

Leads corporate strategy and transformation initiatives across clinical and healthcare management areas. Supports strategy development, planning, market research, implementation, growth, affordability, and technology-enabled operating model transformation. Conducts quantitative and qualitative analysis, generates insights, develops recommendations, manages complex projects, solves problems, and collaborates with senior leadership in a matrixed environment.

Leads engineering delivery across multiple products and scrum teams, managing technical solutions, engineering operations, resource planning, vendor labor, and staff development. Oversees engineering leaders, aligns technology capabilities with product roadmaps, supports strategic initiatives, and manages software development through Agile, Scrum, and iterative methodologies. The role requires expertise in cloud and SaaS platforms, stakeholder management, forecasting, organizational strategy, and building high-performing engineering teams.

Manages analytics, reporting tools, healthcare data sets, and analyst teams supporting risk adjustment programs. Oversees medical record retrieval, high-volume healthcare data processing, reporting, and insights. Coordinates internal stakeholders and external vendors, develops analytical capabilities, evaluates new data sources and methodologies, and supports Medicare, ACA, and risk adjustment operations.

Manages stop-loss underwriting by quoting and rating proposals, projecting renewals, approving cases within authority, and pricing complex group health accounts. Applies underwriting methodologies, funding models, managed care knowledge, and applicable legislation. Leads presentations, customer and broker relationships, cross-functional initiatives, project assignments, process improvements, and staff coordination while exercising independent judgment and meeting deadlines.

Execute audits of financial and operational controls across departments to ensure compliance with policies and procedures. Perform basic accounting and systems analysis, document findings, communicate results, and support process improvements and risk-control initiatives. Collaborate with stakeholders and learn audit methodologies and financial systems.

Support the Intelligent Process Automation Lab by managing business relationships, consolidating demand, prioritizing automation use cases, shaping portfolio strategy and roadmap, expanding RPA/AI PODs, enforcing discovery best practices and governance, and coordinating requirements and delivery with development teams.