Health Care Service Corporation

Data Scientist

• Own one or more Data Science products that add business value.
• Work closely with customers to understand needs and translate them into data science products.
• Write technical requirements and prioritize product development.
• Coordinate with all interested stakeholders for product success.
• Promote usage and understanding of the product across a broad audience.
• Assist with data science and data engineering tasks as needed.

Senior Data Science Product Manager

Actuary

• Participate in implementation, maintenance, and analysis of actuarial models and systems
• Run and develop complicated models
• Perform detailed analysis of results
• Develop simple written and oral presentations for decision making
• Understand basic business and actuarial concepts

Senior Actuarial Analyst

General

• This position is responsible for performing a variety of functions and is a single source of contact for members, health care personnel and all other entities involved in managing care.
• Identifies alternate treatment programs; consults with physicians, providers, members, and other resources to evaluate options and services required to meet an individual’s health needs.
• Promotes quality and cost-effective outcomes; and serves as liaison to physicians and members.
• Other functions also include determining member assignment of treatment, and pre-admission/post-discharge counseling for an acute condition.
• Establish relationship with the members.
• Handle immediate post discharge follow-up or until all short-term care needs are met.
• Provide education/local resource information and encourage member (self) education.
• Functioning in a clinical care advisory role, assessing members for wellness education and disease management, introduces members to our website tools, educates members regarding wellness and specific conditions, and facilitates the coordination of care for identified members.
• Provide oversight to holistic health coordinators.

Holistic Health Specialist

Network Engineer

• Managing, developing and maintaining harmonious working relationships with assigned providers
• Managing provider agreement negotiation operations

Principal Network Management Consultant

Systems Engineer

• Designing, enhancing, and supporting business applications and information systems solutions
• Translating business analyst inputs into technical designs
• Managing incidents and resolving production/test issues
• Supporting application stability and troubleshooting complex problems
• Collaborating with architecture, application services, infrastructure, and release management teams
• Developing operating procedures, user manuals, and knowledge repositories

Associate Systems Analyst

Learning and Development

• Collaboration with departmental and business resources to understand business performance gaps and learning needs
• Accountable for managing overall curricula project initiatives, including the creation of design strategy, detailed needs analysis, and designing and developing relevant adult learning solutions for the business
• The scope includes instructional design and development for instructor-led, web-based, and blended solutions
• Responsible for the coordination of communication plans, curriculum maintenance plans, and project management activities, establish curricula readiness, and the evaluation of learning and business outcomes

Learning & Development Specialist

Operations

• Supports pharmacists addressing medication inquiries and collaborating with entities to resolve pharmacy-related issues.
• Manages inbound calls, conducts member/provider outreach, and collaborates with pharmacists on medication management.
• Supports population health initiatives and participates in data-driven efforts to improve operational outcomes.
• Provides assistance to the customer service team and pharmacy coordinators in resolving pharmacy issues.

Pharmacy Operations Representative

Compliance

• leading the execution of Information Security governance, risk, and compliance programs
• developing and maintaining the compliance framework
• supporting compliance and attestation activities
• oversight of security policy management, exceptions, subsidiary risk, and third-party risk management
• facilitating the identification, reporting, management, and remediation of security risks
• maintaining effective risk tracking and reporting processes
• identifying and recommending improvements to the organization’s security risk management controls

Director, Governance, Risk, Compliance

• Leading a team or multiple teams with primary responsibilities that include ensuring data quality
• Creation of new data pipelines
• Optimization and management of existing data pipelines
• Ingestion and curation of data sources for analytical purposes
• Transformations of structured and unstructured data into formats suitable for machine learning and advanced analytics
• Leading deployment and ensuring products are production-ready and run smoothly
• Working closely with IT on implementation of data products where traditional application development support is needed

Senior Director of Data Science Engineering

Sales

• Sales (IC) Senior Advisor for HealthSpring Supplemental Benefits will be responsible for making HSB a market leader in the Medicare Supplement and individual ancillary products space.
• Help to execute on HSB’s national broker distribution strategy with National Marketing Organizations (NMO’s) and other topline distributors.
• Recruit, train, and motivate a group of external distributors/wholesalers that will deliver industry leading results via business development activities.

Senior Sales Advisor – HealthSpring Supplemental Benefits

Manager

• Responsible for managing daily activities and implementation of strategies for provider recruitment and contracting of physicians, physician groups and facilities.
• Develop and negotiate contracts; maintain relationships with providers and ensure strategic coverage for assigned territory.
• Management, mentoring and training of a team responsible for provider contracting and provider support resources.
• Provide subject matter expertise to improve efficiencies and results.
• Must have the ability and willingness to travel within assigned areas of responsibility, including overnight stays.
• Manage duties include hiring, performance manage, pay administration, change management, talent management.
• Work with internal departments to ensure appropriate implementation of executed agreements.
• Analyze financial reports to determine financial impact of negotiations.
• Ensure strategic objectives are being met with regard to physicians, physician groups and facilities needed for assigned territory.

Manager, Network Management – Healthcare

Architect

• Configure and manage Databricks workspaces, clusters, and jobs
• Optimize data workflows for performance, cost, and scalability
• Integrate Databricks with cloud platforms (Azure, AWS) and external data sources
• Monitor system performance and troubleshoot issues in production environments
• Implement data security, governance, and access controls
• Collaborate with data engineers, data scientists, and business stakeholders
• Support CI/CD pipelines for data and analytics solutions
• Maintain documentation for architecture, processes, and workflows
• Stay up to date with new Databricks features and best practices

Senior Application Architect – Databricks

Senior Application Architect – Azure

Director

• Overseeing enterprise payment transformation efforts including payment strategies and model design, and alternative payment model implementation and end-to-end VBC administration.
• Responsible for VBC strategy including design of new VBC models and enhancement of existing VBC models across all Lines of Business and States and National Network Strategy and Integration.
• Direction and expansion of Value Based Care provider contracting; development, direction and management of competitive provider pricing models, medical economic opportunity analysis and Performance Based Reimbursement programs.
• Assessment of new network VBC target opportunities and value propositions; VBC strategy design, governance and execution.
• Development, promotion and presentation of network advantages/strengths.
• Oversee VBC analytics, provider performance reporting and platforms as well as all payment administration systems including data integration, payment platforms delivery and technical releases, year around operations, audit oversight, and issue resolution.

Executive Director, Payment Transformation

• Direct all negotiations, strategies, and direct execution of the business plan for high value provider partners
• Responsible for market and partner financial and operational engagement strategies
• Develop direct relationships and conduct critical contract negotiations
• Internal cross-functional engagement to further external objectives with partners
• Lead/support strategic plan initiatives involving high value partners
• Work collaboratively with finance, contracting, analytics, and operations areas