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 SummaryThis position is responsible for managing delegation oversight functions to ensure compliance with accreditation standards, Federal, State and Local Regulatory and contractual obligations.This role is responsible for managing implementation and auditing oversight of delegation. Oversight processes, requirements, and tools. Responsible for monitoring and identifying potential areas of noncompliance by conducting annual and investigational audits and / or performing compliance reviews and performing risk assessments; and reporting identified performance or compliance issues to leadership.
Provides advice and guidance to operational areas regarding proper policies and procedures. Ensures the integrity, auditability, and accuracy of reported data. Represents the company in external audits and compliance matters as well as regulatory meetings and activities.
Additionally, this position will collaborate with internal and external business partners to provide guidance and recommendations around the development, maintenance and enhancements of programs, products and services. Ability and willingness to travel to Provider's locations and other HCSC Sites.
JOB REQUIREMENTS:
- Bachelor's Degree with 5 years experience in business or healthcare or 7 years health insurance operations experience,
- 4 years' experience in project management and implementations
- 2 years supervisory or team leadership experience
- Experience in performing delegation oversight and monitoring multiple delegated functions,
- Knowledge of NCQA. CMS regulations and Managed Care
- Executive presence with the ability to influence internal and external partners.
- Experience managing multiple small to large projects in a cross-functional environment
- Ability to interact effectively with all levels of internal and external customers
- Operations experience including coordination of problem resolution through various departments
- Proven problem-solving ability and experience in managing multiple assignments with critical deadlines
- Excellent data analysis, reporting, and presentation skills
- Strong team development, coaching, negotiation, and ethical decision-making skills
- Ability and willingness to travel to provider's locations and other HCSC sites.
- PC proficiency to include Excel, Adobe Visio, Word and Power Point.
This is a Flex (Hybrid) role: 3 days in office; 2 days remote.
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$90,900.00 - $164,200.00Similar Jobs
What We Do
Imagine Something New, Something Different.
Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), is the largest customer-owned health insurer in the nation and the fourth largest overall. Operating through our Blue Cross and Blue Shield Plans in Illinois, Montana, New Mexico, Oklahoma and Texas (as well as a variety of affiliates and subsidiaries,) we are expanding access to high-quality, cost-effective health care. We are equipping members with information and tools so they can make the best health care decisions for themselves and their families.
HCSC is continuously recognized as an employer committed to community, diversity and inclusion, training and development.
HCSC is committed to pioneering the health care space in ways as effective as they are creative. If you are passionate about the impact you want to have through your work, with a desire to apply innovative thinking to new and emerging challenges, we encourage you to learn more about HCSC.
Learn about what we stand for, how we work and the difference we’re making in the lives of our 15 million members. Join HCSC and discover what new ways of thinking can mean for you, your community, our customers and our organization.
Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.
