Logo of Huzzle

Sr Network Innovation/Strategy Consultant

  • Job
    Full-time
    Senior & Expert Level
  • Business, Operations & Strategy
    Consulting
  • Albuquerque
  • Quick Apply

AI generated summary

  • You need strong experience in managed care, provider contracting, financial analysis, innovation, and strategy. Excellent communication, analytical, and consultative skills are essential. Experience with network management trends and building credibility is a must.
  • You will drive value-based care and new network strategy, focusing on innovative solutions, provider contracting, competitive pricing, and network development.

Requirements

  • Bachelor’s degree and 6 years managed care or network management experience at the Health Plan level or 10 years managed care or network management experience at the Health Plan level.
  • Experience in provider contracting and negotiations.
  • Experience in financial analysis related to provider reimbursement, payment methodologies and provider performance measures.
  • Innovation and strategy skills
  • Consultative skills
  • Analytical skills and experience developing analytical presentation and pricing models.
  • Clear, concise and effective verbal and written communication skills including interpersonal and presentation skills.
  • Strategic thinking, critical thinking and problem-solving skills.
  • Business acumen and ability to build credibility with all levels of the organization.
  • Financial acumen
  • Independence, resourcefulness, and ability to meet deadlines.
  • Knowledge of healthcare benefits, terminology, and concepts.
  • Experience developing and presenting to executives or provider groups; strong delivery skills.
  • Knowledge of network management trends and innovations.
  • Ability to collaborate effectively with stakeholders and key internal partners.
  • PREFERRED JOB REQUIREMENTS:
  • Master’s degree
  • Experience in developing and writing value based provider contracts
  • Experience in use of membership data, premium data and/or claims data.
  • Knowledge of State and Federal laws and regulations.
  • Experience with network management pricing modeling.
  • Experience in innovation

Responsibilities

  • This position is responsible for value-based care and new network strategy and development activities at an advanced consultative level to enhance market stance, competitive capabilities and profitability. Responsible for the identification, evaluation and development of innovative network / care management solutions; direction and expansion of value based care provider contracting (patient center medical home, aco, bundled payment models, specialty payment models, etc.); identification and evaluation of competitive provider pricing models, high economic value and performance based reimbursement programs; assessment of new network opportunities and value propositions; and development, promotion and presentation of network advantages/strengths.

FAQs

What does a Sr Network Innovation/Strategy Consultant do at HCSC?

A Sr Network Innovation/Strategy Consultant at HCSC is responsible for creating and implementing innovative strategies to improve network performance and drive business growth. They work closely with internal teams to identify opportunities for optimization and develop solutions to enhance network capabilities.

What development opportunities are available for Sr Network Innovation/Strategy Consultants at HCSC?

HCSC offers personalized development plans for Sr Network Innovation/Strategy Consultants to help them grow and advance in their career. Employees have access to training programs, mentorship opportunities, and resources to support their professional development.

How does HCSC support the career growth of Sr Network Innovation/Strategy Consultants?

HCSC invests in the career growth of Sr Network Innovation/Strategy Consultants by providing them with opportunities to take on new challenges, learn new skills, and expand their knowledge in the field. Additionally, employees have the chance to contribute to innovative projects that have a real impact on the business.

What sets HCSC apart as an employer for Sr Network Innovation/Strategy Consultants?

HCSC is a purpose-driven company that values its employees and invests in their future. Sr Network Innovation/Strategy Consultants at HCSC have the opportunity to work on meaningful projects, collaborate with talented teams, and make a difference in the healthcare industry. The company also offers a supportive and inclusive work environment where employees can thrive and succeed.

Empowering Whole Person Health With Compassion and Innovation

Science & Healthcare
Industry
10,001+
Employees

Mission & Purpose

Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), is an Independent Licensee of the Blue Cross and Blue Shield Association. We are the largest customer-owned health insurer in the United States, serving more than 18.6 million members through our Plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. For nearly a century, we have enabled and coordinated the access to quality care for millions of members. Our experience and industry knowledge establishes a solid foundation for our future—driving innovations that further expand access, improve health outcomes, and reduce costs. Embedded within the fabric of how we operate is a deep sense of caring and commitment that informs how we serve our members, engage in local communities, and deliver positive change to the health care industry. As health care needs evolve, we leverage our portfolio of companies to deliver differentiated value to all industry stakeholders so that, together, we make more possible.