Network Management Consultant - Work From Home

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 Summary This is a detail-oriented Negotiation Specialist position to support the team in managing Senate Bill 1264 Texas cases. This role is responsible for handling a This role manages a defined book of business and is responsible for handling a caseload of both informal and formal disputes involving out-of-network providers under Texas Senate Bill 1264 (SB 1264). The Network Management Consultant independently evaluates reimbursement disputes, applies applicable regulatory guidelines, and facilitates resolution through structured negotiation and case management. This role requires strong analytical and communication skills, the ability to manage multiple concurrent cases, and a solid understanding of healthcare reimbursement methodologies, provider contracting, and regulatory dispute processes. The Consultant ensures timely, accurate, and compliant resolution of assigned cases while maintaining effective communication with internal and external stakeholders. This position plays a key role in driving consistent case outcomes and operational efficiency within a high-volume regulatory environment, with the possibility to progress into a Sr. Network Management Consultant role over time. Required Job Qualifications: Bachelor Degree and at least one year experience developing and negotiating provider contracts OR 5 years managed care operations experience handling independent work with at least one year experience developing and negotiating provider contracts. Meet deadlines and work well under pressure. Verbal and written communication skills, organizational and planning skills. PC proficiency to include Microsoft Office. Analytical skills. Ability and willingness to travel within assigned territory, including overnight stays. Preferred Job Qualifications: Experience with Excel, specializing in Vlook ups & Pivot Tables. Knowledgeable of the TX SB1264 Law. Effective time management skills. This is a Telecommuter (Remote) role Sponsorship is not available #LI-LO1 #LI-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 $55,900.00 - $123,500.00 Exact compensation may vary based on skills, experience, and location. Apply To This Job