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$62k–$136k/yr
Full-time
bachelor degree
Health and wellness benefits, 401(k) savings plan, Pension plan, Paid time off, Paid parental leave, Disability insurance
Posted 13d ago
~40 hrs/week
Responsibilities
This role supports the evaluation of government program regulations and assesses compliance risks within HCSC contracts. The consultant will collaborate with business units to implement controls, monitor operational compliance, and develop remediation strategies for identified issues.
Requirements
Candidates must possess a bachelor's degree and at least three years of experience in health plans, regulatory compliance, or risk management. Strong communication, critical thinking, and analytical skills are required to effectively manage relationships with internal and external stakeholders.
Full job description
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
BASIC FUNCTION This position is responsible for supporting evaluation of government programs (Medicare and Medicaid) regulations, guidance and contracts, assessing the risk that those items present with respect to HCSC government contracts. Supporting the compliance department oversight of the business operational compliance with the requirements through multiple mechanisms such as review of reports, attendance at operational meetings, and targeted monitoring of areas of concern. Assisting in identification of risks and issues of noncompliance, development of strategies to mitigate and remediation of those risks and issues and work with compliance and business personnel, all levels of HCSC management and governmental agencies in order to implement controls and processes and report on results
NOTE: this role is HYBRID/FLEX and requires in-office visibility three days per week, working from home the other two days. Relocation is not available and sponsorship will NOT be extended either now or in the future ~
JOB REQUIREMENTS
Bachelor’s degree and 3 years experience in health plans, regulatory compliance or risk management OR 6 years’ experience in health plans, regulatory compliance or risk management.
Ability to communicate with and build relationships with internal business units and/or various external government agencies.
Critical thinking, risk assessment and mitigation.
Excellent verbal and written communication skills.
Ability to work with minimal supervision.
Organizational, analytical and decision-making skills.
PC proficiency to include Workday, Word, PowerPoint and Excel.
PREFERRED REQUIREMENTS
Government Programs Healthcare Compliance experience. Equivalent experience will be considered.
Knowledge of Medicaid contracts and regulations, Medicare Advantage, Part D or other regulatory experience.
Bachelor’s Degree or higher preferred.
Government programs operational experience.
~ KEY FUNCTIONS ~
Will identify, review, analyze and understand contractual and regulatory requirements. Evaluate Government regulations, guidance and contracts, and identify specific risks that they present to HCSC government contracts. Review Government Programs policies and procedures, workflows, training materials and other documentation for compliance with requirements. Consult with the business and provide guidance as the business plans, implements and monitors its compliance with contractual and regulatory requirements. Identify and follow up on compliance issues and track issues to resolution. Provide accurate and complete documentation of reported information, risks, issues, status and results. Work with the business to agree upon issues, root causes, remediation steps, deliverables, additional training and education, communications, internal controls, compliance reviews or modifications to processes and due dates. Participate in issue resolution process which may include, as appropriate, but is not limited to:
identifying barriers to meeting due dates
identifying actions or escalations needed to address barriers
escalating failure to meet due dates
escalating barriers appropriately
recommending disciplinary actions or other appropriate means to hold business owners accountable for actions or lack of actions.
Validate that business remediation activities successfully addressed agreed-upon root causes, deliverables and remediation steps. Participate in remediation activities including: identification of root cause(s), identification and stratification of risks, development and implementation of recommendations for processes that would result in their mitigation. Assist in development of remediation plans with the business including setting agreed-upon actions, deliverables and due dates and track execution of the remediation plan. Consult with business owners, which may include participating in regular meetings, working with management to identify and mitigate risks and coordinating responses to questions from regulators. Communicate with internal and external stakeholders at all levels throughout HCSC to achieve effective outcomes. Perform targeted monitoring and/or reviews to determine if HCSC is in compliance with the terms of specific government contracts, regulations, guidance and private contracts. Document results and communicate findings to the business. Provide input related to the Risk Assessment process in order to most effectively stratify the risks presented by government business. Coordinate, facilitate and take notes at internal and external meetings, including meetings with regulators. Prepare and distribute materials to participants. Review operational reports from the business, track and trend results and identify issues or risks of noncompliance. Create summary reports for management on issues and risks of non-compliance. Report on Compliance Program activities, effectiveness and status, including ad hoc and routine management reports. * Contribute to preparation of quarterly compliance reports to HCSC boards and committees
NOTE: this role is HYBRID/FLEX and requires in-office visibility three days per week, working from home the other two days. Relocation is not available and sponsorship will NOT be extended either now or in the future ~
#LI-TP1
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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
$61,500.00 - $136,100.00
Exact compensation may vary based on skills, experience, and location.
Related keywords
Government ProgramsMedicare AdvantagePart DRegulatory ComplianceRisk ManagementHealth PlansCompliance MonitoringOperational ComplianceContractual RequirementsRemediation PlanningRoot Cause AnalysisInternal ControlsStakeholder EngagementWorkdayMicrosoft OfficeReporting
Empowering Member Health With Compassion and Innovation
Industry
Hospitals and Health Care
Company size
10,001+ employees
Headquarters
Chicago, IL
LinkedIn followers
166,695
Health Care Service Corporation serves nearly 23 million people across the United States through its portfolio of health benefit solutions.
HCSC provides health coverage options for employers large and small, individuals and families, and Medicare and Medicaid plans. HCSC also offers related health care products and services such as pharmacy solutions, life and dental insurance, and health data technology. A Mutual Legal Reserve Company, HCSC is an independent licensee of the Blue Cross Blue Shield Association.
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.
Join HCSC and discover what new ways of thinking can mean for you, your community, our customers and our organization: HCSC.com/careers. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to an inclusive, drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability, or protected veteran status.
Image(s) may have been created or enhanced using artificial intelligence tools.
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Based on 5214 listings with disclosed salaries, most healthcare jobs in Illinois pay between $67k–$190k per year. Individual offers vary with seniority, company size, and specialization.
How many Healthcare jobs are open in Illinois right now?
There are currently 23,537 open healthcare positions in Illinois listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Healthcare roles in Illinois?
Companies currently hiring include Northwestern Medicine, OSF HealthCare, Nevada System of Higher Education, Allergan, American Addiction Centers, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Healthcare jobs in Illinois?
Yes — 2371 of the 23537 open healthcare positions offer remote or hybrid work (854 remote, 1517 hybrid).
How do I apply for Healthcare jobs in Illinois?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.