Health Care Service Corporation

Customer Support

• Responsible for the day-to-day supervision and management of a remote team of customer service representatives
• Enable the team to deliver exceptional service
• Achieve client service expectations
• Manage staff development

Customer Service Supervisor

• Supervise and oversee performance, staff development and day-to-day operations of an assigned team to support HCSC Customer Service strategic goals and objectives.
• Accountable for identifying and understanding strengths and opportunities of individuals and the larger team.
• Build upon strengths to enhance the team and coach employees to serve members, providers, and stakeholders.
• Maintain a safe and healthy work environment by enforcing organizational standards and core values.

Supervisor, Customer Service

Medical Director

• drive strategy and ensure clinical excellence in clinical programs, Stars, risk adjustment and total cost of care
• strengthen partnerships with providers and health systems in the Market
• work closely with Independent Physician Associations (IPA), health systems, aligned managed service organizations (MSO) and independent practices

Market Medical Director

Systems Engineer

• Support and maintain automations developed on the UiPath RPA platform
• Enhance existing solutions, ensuring optimal performance
• Maintain adherence to defined specifications
• Serve as a technical lead to identify the most effective solution approaches within the UiPath environment
• Translate business requirements and architectural direction into scalable, high-quality solutions
• Collaborate with stakeholders to ensure successful automation outcomes
• Participation in an On-Call rotation may be required

Senior Systems Analyst – UiPath

Data Scientist

• Provide leadership and strategic direction in solving business problems using advanced mathematical and statistical methods.
• Build advanced time-series models to forecast trends in medical spend using hierarchical Bayesian models and temporal fusion transformers.
• Ensure scientific rigor and reproducibility of model evaluation.
• Optimize models for accuracy and interpretability.
• Communicate findings to stakeholders from technical ICs to top leadership.

Principal Data Scientist

• Designing enhancements and new business applications
• Integration of technical and business requirements
• Serving as technical designer to identify best solution
• Ensure integrity, security, and scalability of databases
• Proactive monitoring and management activities for applications

Senior Systems Analyst

Consultant

• Supporting business analysis to ensure alignment and integration across functional areas
• Supporting efforts to track progress of the division’s activities to goals
• Implementing initiatives with basic to moderate complexity that affect multiple functional areas within the division

Business Consultant

• Designing Enhancements And New Business Applications And/Or Information Systems Solutions Through Integration Of Technical And Business Requirements
• Serving As Technical Designer To Identify Best Solution And Resulting Technical Specifications Within Limits Of Code Environment
• Linking Business Analyst Needs And Architect Definition To Technical Solutions

Systems Analyst

Actuary

• Managing the implementation, maintenance and critical review and analysis of models, studies and systems which use actuarial principles for the purposes of pricing, underwriting, statistics, reserving, forecasting and other actuarial functions
• Developing complicated models and teaching others how to develop models
• Developing written and oral presentations that drive the delivery of information for decision making
• Managing day-to-day projects that may include non-actuarial departments
• Possessing and demonstrating a deep understanding of one actuarial area or business segment

Managing Actuary

• Designing enhancements and new business applications and/or information systems solutions through integration of technical and business requirements
• Serving as technical designer to identify best solution and resulting technical specifications
• Linking Business Analyst needs and Architect definition to technical solutions
• Ensuring the integrity, security, scalability, and daily availability of the application to meet business needs

Security Engineer

• Project management and leadership of major, complex, and strategic cross-divisional and enterprise-wide projects from inception to completion for the Fraud division
• Oversight, coordination, and ability to implement projects according to dynamic and critical timelines
• Oversight of project teams, resources, and budget; and interacting with all levels of management including senior management
• Assume project accountability and ensure appropriate deliverables are met
• Formulate action plans to develop and implement projects
• Strong communication skills and the ability to present information accurately and concisely both orally and in writing
• Maintain communication with management regarding development within areas of assigned responsibility and perform special projects as required or requested

Project Management Consultant – Fraud & Security

Auditor

• Performing clinical, billing, coding and lowest cost setting reviews for services pre and post payment
• Utilizing medical, contractual, legislative, policy, and other information to validate claims submitted and billed
• Conducting research
• Preparing documentation of findings
• Consulting with medical directors as needed
• Coordination with all departments involved in each case required such as special investigations, customer service, pass, network management, marketing, case management, medical review, legal, pricing and database.

Coding Investigator Auditor

Communications

• developing and executing a variety of communications to meet the needs of multiple audiences through interaction with clients and management at all levels of the corporations;
• drafts, edits and supervises the production of communications (print, web, etc) to be distributed to a variety of audiences;
• acts as a mentor to other team members.

Senior Communications Consultant

Artificial Intelligence

• Rely on a strong background in machine learning development and evaluation to assess AI initiatives for alignment with HCSC AI Governance best practices.
• Refine requirements for building, deploying, and monitoring AI from internal and external sources.
• Work with project teams to refine submissions and ensure projects meet requirements.
• Identify updates to AI policies from external agencies and how these align to current HCSC best practices.
• Intake evaluation requests from internal partners and design enhancements to current best practices.
• Communicate effectively with cross-functional partners and leadership.
• Represent AI Governance in meetings internal and external to HCSC.
• Complete project leadership responsibilities and adhere to project plans.

Senior AI Governance Standards Consultant

Director

• Responsible for planning, managing and controlling the activities of the department that provides business intelligence support for business segments;
• Leading initiatives to analyze complex business problems and issues using data from internal and external sources; bringing expertise or identifying subject matter experts in support of multi-functional efforts to identify, interpret and produce recommendations and plans based on company and external data analysis;
• Advising business by providing data-based strategic direction to identify and address business issues and opportunities;
• Ensuring that policies and procedures align with corporate vision;
• selecting, developing and evaluating personnel ensuring efficient operation of the function.

Customer Service Supervisor

Supervisor, Customer Service

Market Medical Director

Senior Systems Analyst – UiPath

Principal Data Scientist

Senior Systems Analyst

Business Consultant

Systems Analyst

Managing Actuary

Senior Systems Analyst

Project Management Consultant – Fraud & Security

Coding Investigator Auditor

Senior Communications Consultant

Senior AI Governance Standards Consultant

Senior Director, Analytics Consulting