Senior Provider Network Representative
Health Care Service Corporation · Austin, TX · 1 mo ago
Information Technology$56k–$124k/yrFull-time
We need to produce HTML fragment with sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections where there is real specific content. Must not repeat job title. Must not include Job ID etc. Must remove boilerplate, EEO, etc. Must preserve all substantive info.
Let's parse the posting.
Paragraph: "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." This is about the company, could be "About the role"? Actually it's about the company, but we can put under "About the role" maybe. The instruction: use for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). So we can have About the role.
Then: "This position is responsible for planning and directing provider recruitment and contracting activities; educating providers on plan benefits, policies, procedures, and reimbursement processes; providing ongoing provider service and support; resolving complex provider issues; serving as a liaison between providers and internal business partners; and providing training to new and existing network staff." That's responsibilities.
Then "Required Job Qualifications Bachelor’s degree in business OR 6 years leadership experience.4 years’ experience in claims, customer service, physician office or hospital or healthcare environment.3 years’ experience in a position which requires in-depth physician/provider relations, including but not limited to, contracting and reimbursement issues.Ability to negotiate and contract with healthcare providers.Platform skills; organizational and planning skills; and ability to take initiative and work independently.Ability to multi-task; meet deadlines and work well under pressure.Ability and willingness to travel within assigned areas of responsibility, including overnight stays.PC proficiency to include Microsoft Office"
We need to separate required qualifications vs preferred qualifications. The posting has "Required Job Qualifications" then a list. Then "Preferred Job Qualifications" then list.
We need to decide sections: Requirements (maybe required qualifications), Qualifications (maybe preferred?), Skills (maybe platform skills). But we have to follow the given headings list: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule.
We need to map content accordingly.
- About the role: company intro paragraph.
- Responsibilities: the bullet list of duties.
- Requirements: required qualifications (Bachelor's degree OR 6 years leadership experience, 4 years experience in claims etc, 3 years experience in physician/provider relations, ability to negotiate, platform skills, organizational and planning skills, initiative, multi-task, meet deadlines, work under pressure, travel willingness, PC proficiency MS Office). Could be a list.
- Qualifications: preferred qualifications (demonstrated success building relationships, experience conducting provider education, experience resolving complex claims, extensive Medicaid and Medicare Advantage experience, knowledge of healthcare contracting, reimbursement methodologies, managed care operations, prior territory management experience, knowledge of BCBSTX claims processing systems). Could be a list.
- Skills: maybe we could combine platform skills etc but we already used them in Requirements. However we could still have a Skills section for specific skills like negotiation, PC proficiency, etc. But we must not create thin sections. Better to incorporate skills into Requirements or Qualifications. Since we have both Required and Preferred, we could put Required under Requirements, Preferred under Qualifications, and maybe Skills could be omitted if no distinct skill list beyond those. But we have platform skills etc already in Required. Could we still have a Skills section for "Platform skills; organizational and planning skills; ability to take initiative and work independently; ability to multi-task; meet deadlines; work well under pressure; ability and willingness to travel; PC proficiency to include Microsoft Office"? That seems like skills. But we already used them in Requirements. Might be duplication. Better to follow the headings: Requirements for required qualifications (education/experience), Qualifications for preferred qualifications, Skills for abilities/skills (negotiate, platform skills, organizational, initiative, multi-task, deadlines, pressure, travel, PC proficiency). However the required qualifications list includes those abilities; we could split them.
But we must not invent or summarize away detail. We need to preserve all substantive information. So we need to include all points somewhere.
Let's extract all statements:
From Responsibilities:
- planning and directing provider recruitment and contracting activities
- educating providers on plan benefits, policies, procedures, and reimbursement processes
- providing ongoing provider service and support
- resolving complex provider issues
- serving as a liaison between providers and internal business partners
- providing training to new and existing network staff
Required Job Qualifications:
- Bachelor’s degree in business OR 6 years leadership experience
- 4 years’ experience in claims, customer service, physician office or hospital or healthcare environment
- 3 years’ experience in a position which requires in-depth physician/provider relations, including but not limited to, contracting and reimbursement issues
- Ability to negotiate and contract with healthcare providers
- Platform skills; organizational and planning skills; and ability to take initiative and work independently
- Ability to multi-task; meet deadlines and work well under pressure
- Ability and willingness to travel within assigned areas of responsibility, including overnight stays
- PC proficiency to include Microsoft Office
Preferred Job Qualifications:
- Demonstrated success building and maintaining relationships with physician groups, hospitals, and provider leadership
- Experience conducting provider education, training, and face-to-face consultations
- Experience resolving complex claims, reimbursement, and payment issues for providers
- Extensive Medicaid and Medicare Advantage experience
- Knowledge of healthcare contracting, reimbursement methodologies, and managed care operations
- Prior territory management experience
- Knowledge of BCBSTX claims processing systems
Additional Details:
- Client-site Location: This is a field-based position in the Austin Texas market that requires provider office visits.
- Sponsorship: Sponsorship is not available
- Compensation: $55,900.00 - $123,500.00 Exact compensation may vary based on skills, experience, and location
- HCSC Employment Statement (EEO) - remove
- Link to benefits - we should include benefits? The posting says "To learn more about available benefits, please click ..." but no specific benefits listed. So we cannot create Benefits section because no specific benefits listed. According to rule: never create Pay/Schedule/Benefits sections unless the posting actually states them. So we should not create Benefits section because no specific benefits listed. However we have Compensation (Pay) stated: $55,900 - $123,500. So we can create Pay section.
Schedule: Not mentioned. So no Schedule section.
Thus sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Pay.
We need to decide what goes where.
We could put:
- About the role: the introductory paragraph about HCSC.
- Responsibilities: the list of duties.
- Requirements: the required qualifications (education/experience). Could also include the ability to negotiate? But that's a skill. Might be better to put abilities under Skills.
But the instruction: "Use
for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). So we can have About the role.
Then: "This position is responsible for planning and directing provider recruitment and contracting activities; educating providers on plan benefits, policies, procedures, and reimbursement processes; providing ongoing provider service and support; resolving complex provider issues; serving as a liaison between providers and internal business partners; and providing training to new and existing network staff." That's responsibilities.
Then "Required Job Qualifications Bachelor’s degree in business OR 6 years leadership experience.4 years’ experience in claims, customer service, physician office or hospital or healthcare environment.3 years’ experience in a position which requires in-depth physician/provider relations, including but not limited to, contracting and reimbursement issues.Ability to negotiate and contract with healthcare providers.Platform skills; organizational and planning skills; and ability to take initiative and work independently.Ability to multi-task; meet deadlines and work well under pressure.Ability and willingness to travel within assigned areas of responsibility, including overnight stays.PC proficiency to include Microsoft Office"
We need to separate required qualifications vs preferred qualifications. The posting has "Required Job Qualifications" then a list. Then "Preferred Job Qualifications" then list.
We need to decide sections: Requirements (maybe required qualifications), Qualifications (maybe preferred?), Skills (maybe platform skills). But we have to follow the given headings list: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule.
We need to map content accordingly.
- About the role: company intro paragraph.
- Responsibilities: the bullet list of duties.
- Requirements: required qualifications (Bachelor's degree OR 6 years leadership experience, 4 years experience in claims etc, 3 years experience in physician/provider relations, ability to negotiate, platform skills, organizational and planning skills, initiative, multi-task, meet deadlines, work under pressure, travel willingness, PC proficiency MS Office). Could be a list.
- Qualifications: preferred qualifications (demonstrated success building relationships, experience conducting provider education, experience resolving complex claims, extensive Medicaid and Medicare Advantage experience, knowledge of healthcare contracting, reimbursement methodologies, managed care operations, prior territory management experience, knowledge of BCBSTX claims processing systems). Could be a list.
- Skills: maybe we could combine platform skills etc but we already used them in Requirements. However we could still have a Skills section for specific skills like negotiation, PC proficiency, etc. But we must not create thin sections. Better to incorporate skills into Requirements or Qualifications. Since we have both Required and Preferred, we could put Required under Requirements, Preferred under Qualifications, and maybe Skills could be omitted if no distinct skill list beyond those. But we have platform skills etc already in Required. Could we still have a Skills section for "Platform skills; organizational and planning skills; ability to take initiative and work independently; ability to multi-task; meet deadlines; work well under pressure; ability and willingness to travel; PC proficiency to include Microsoft Office"? That seems like skills. But we already used them in Requirements. Might be duplication. Better to follow the headings: Requirements for required qualifications (education/experience), Qualifications for preferred qualifications, Skills for abilities/skills (negotiate, platform skills, organizational, initiative, multi-task, deadlines, pressure, travel, PC proficiency). However the required qualifications list includes those abilities; we could split them.
But we must not invent or summarize away detail. We need to preserve all substantive information. So we need to include all points somewhere.
Let's extract all statements:
From Responsibilities:
- planning and directing provider recruitment and contracting activities
- educating providers on plan benefits, policies, procedures, and reimbursement processes
- providing ongoing provider service and support
- resolving complex provider issues
- serving as a liaison between providers and internal business partners
- providing training to new and existing network staff
Required Job Qualifications:
- Bachelor’s degree in business OR 6 years leadership experience
- 4 years’ experience in claims, customer service, physician office or hospital or healthcare environment
- 3 years’ experience in a position which requires in-depth physician/provider relations, including but not limited to, contracting and reimbursement issues
- Ability to negotiate and contract with healthcare providers
- Platform skills; organizational and planning skills; and ability to take initiative and work independently
- Ability to multi-task; meet deadlines and work well under pressure
- Ability and willingness to travel within assigned areas of responsibility, including overnight stays
- PC proficiency to include Microsoft Office
Preferred Job Qualifications:
- Demonstrated success building and maintaining relationships with physician groups, hospitals, and provider leadership
- Experience conducting provider education, training, and face-to-face consultations
- Experience resolving complex claims, reimbursement, and payment issues for providers
- Extensive Medicaid and Medicare Advantage experience
- Knowledge of healthcare contracting, reimbursement methodologies, and managed care operations
- Prior territory management experience
- Knowledge of BCBSTX claims processing systems
Additional Details:
- Client-site Location: This is a field-based position in the Austin Texas market that requires provider office visits.
- Sponsorship: Sponsorship is not available
- Compensation: $55,900.00 - $123,500.00 Exact compensation may vary based on skills, experience, and location
- HCSC Employment Statement (EEO) - remove
- Link to benefits - we should include benefits? The posting says "To learn more about available benefits, please click ..." but no specific benefits listed. So we cannot create Benefits section because no specific benefits listed. According to rule: never create Pay/Schedule/Benefits sections unless the posting actually states them. So we should not create Benefits section because no specific benefits listed. However we have Compensation (Pay) stated: $55,900 - $123,500. So we can create Pay section.
Schedule: Not mentioned. So no Schedule section.
Thus sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Pay.
We need to decide what goes where.
We could put:
- About the role: the introductory paragraph about HCSC.
- Responsibilities: the list of duties.
- Requirements: the required qualifications (education/experience). Could also include the ability to negotiate? But that's a skill. Might be better to put abilities under Skills.
But the instruction: "Use for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule)." It doesn't strictly define what each must contain, just examples. So we can allocate content logically.
We need to preserve all substantive info. Let's allocate:
About the role: company intro paragraph.
Responsibilities: duties list.
Requirements: education/experience requirements (Bachelor's degree OR 6 years leadership; 4 years experience in claims etc; 3 years experience in physician/provider relations). That's three bullet points.
Qualifications: preferred qualifications list (relationship building, provider education, complex claims resolution, Medicaid/Medicare experience, knowledge of healthcare contracting, territory management, BCBSTX claims processing).
Skills: abilities/skills list (negotiate and contract with healthcare providers; platform skills; organizational and planning skills; ability to take initiative and work independently; ability to multi-task; meet deadlines and work well under pressure; ability and willingness to travel; PC proficiency to include Microsoft Office).
Pay: compensation range.
We must not include boilerplate like EEO, sponsorship, location? Location is substantive: "Client-site Location: This is a field-based position in the Austin Texas market that requires provider office visits." This is location detail. Should we include it? It's not in the headings list but we could incorporate into About the role or Responsibilities? Could add a short paragraph under About the role or maybe a separate section like "Location" but not allowed headings. We could fold minor metadata into a short
or drop it. The instruction: "do NOT put Job ID / requisition numbers as headings — fold minor metadata into a short
or drop it." Location is minor metadata? It's substantive but could be folded into a short p under About the role or Responsibilities. Probably best to add a paragraph under About the role after the intro: "This is a field-based position in the Austin Texas market that requires provider office visits." Also sponsorship not available is minor metadata; we could drop it or fold into a short p. Probably drop it as not essential. Thus About the role will have two paragraphs: the intro and the location note. Now we need to output HTML fragment only, no /. Use
for each section heading, then content:
for prose,
- for lists.
We must not repeat job title as heading.
Let's craft.
Section About the role:
About the role
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.
This is a field-based position in the Austin Texas market that requires provider office visits.
Responsibilities:Responsibilities
- Planning and directing provider recruitment and contracting activities
- Educating providers on plan benefits, policies, procedures, and reimbursement processes
- Providing ongoing provider service and support
- Resolving complex provider issues
- Serving as a liaison between providers and internal business partners
- Providing training to new and existing network staff
Requirements
- Bachelor’s degree in business OR 6 years of leadership experience
- 4 years’ experience in claims, customer service, physician office or hospital or healthcare environment
- 3 years’ experience in a position requiring in‑depth physician/provider relations, including contracting and reimbursement issues
Qualifications
- Demonstrated success building and maintaining relationships with physician groups, hospitals, and provider leadership
- Experience conducting provider education, training, and face‑to‑face consultations
- Experience resolving complex claims, reimbursement, and payment issues for providers
- Extensive Medicaid and Medicare Advantage experience
- Knowledge of healthcare contracting, reimbursement methodologies, and managed care operations
- Prior territory management experience
- Knowledge of BCBSTX claims processing systems
Skills
- Ability to negotiate and contract with healthcare providers
- Platform skills; organizational and planning skills; and ability to take initiative and work independently
- Ability to multi‑task; meet deadlines and work well under pressure
- Ability and willingness to travel within assigned areas of responsibility, including overnight stays
- PC proficiency to include Microsoft Office
Pay
$55,900.00 - $123,500.00 (exact compensation may vary based on skills, experience, and location)