Qureos Mentor

Health Care Service Corporation

<div><div>Chicago, IL Full time 07/11/2026 R0054797 Compensation: $92,700.00 - $167,500.00
</div><div><div>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.
BASIC FUNCTION HCSC is looking for a dynamic individual to join its Fraud Investigations team! This position will be responsible for managing healthcare fraud and internal fraud investigations initially focusing on IL Medicaid; managing and training investigators as well as support staff; establishing and maintaining liaison with healthcare providers and law enforcement; and coordinating anti-fraud activities with other departments at HCSC. The role is hybrid flex and requires in-office visibility three days per week, working from home the other two days. NOTE: relocation is NOT offered, sponsorship will NOT be extended either now or in the future. 
JOB REQUIREMENTS:<ul><li>
Bachelor&rsquo;s Degree in Criminal Justice, Finance or Accounting or related field and 5 years of direct law enforcement/investigation experience, including supervision of cases and investigators OR 9 years of direct professional work experience in the detection, investigation and/or prosecution of complex health care fraud schemes with the following professional certifications: Accredited Healthcare Fraud Investigator (AHFI), Certified Professional Coder (CPC), and/or Certified Fraud Examiner (CFE).</li><li>
1 year of leadership or supervisory experience.</li><li>
Strong organizational skills and results oriented with demonstrated leadership capabilities.</li><li>
Keen analytical, interviewing, and investigative skills, with proficiency in data analysis and claims management systems.</li><li>
Deep understanding of insurance fraud techniques, claims handling, and regulatory compliance.</li><li>
Proficiency in anti-fraud analytics tools, case management software, and MS Office (Word, Excel, PowerPoint) as well as Workday.</li></ul>
PREFERRED JOB REQUIREMENTS:<ul><li>
Master&rsquo;s Degree.</li><li>
Experience with IL Medicaid FWA investigations.</li></ul>
~KEY FUNCTIONS ~<ul><li>
Develop and manage investigative group designed to detect, investigate, and refer health care fraud cases to law enforcement.</li><li>
Ensure evidence collected, including documents and interview reports, are maintained in a manner to ensure integrity in court proceedings.</li><li>
Ensure personnel are properly trained and managed in investigative techniques.</li><li>
Prepare weekly investigative and activity reports.</li><li>
Coordinate with other HCSC departments concerning ongoing anti-fraud programs and procedures.</li><li>
Develop and maintain sources of information needed to detect health care fraud.</li><li>
Develop and maintain liaison contacts with law enforcement.</li><li>
Direct and supervise sensitive investigations when appropriate.</li><li>
Deal directly with HCSC customers on fraud matters when appropriate.</li><li>
Conduct monthly file reviews and provide direction to investigators regarding investigative strategies and plans.</li><li>
Coordinate investigative activities with the Legal Department.</li><li>
Ensure investigators are familiar and utilize health care fraud databases, including Fraud and Abuse Management System (FAMS).</li><li>
Comply with federal and state reporting and fraud investigation requirements.</li><li>
Communicate and interact effectively and professionally with co-workers, management, customers, etc.</li><li>
Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.</li><li>
Maintain complete confidentiality of company business.</li><li>
Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested</li></ul>
#LI-TP1
#LI-hybrid
Compensation: $92,700.00 - $167,500.00
Exact compensation may vary based on skills, experience, and location
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. 
To learn more about available benefits, please visit https://careers.hcsc.com/totalrewards( opens in new window)</div></div></div>

Manager Special Investigations

<div><div>Chicago, IL Full time 07/11/2026 R0050758 Compensation: $55,900.00 - $123,500.00
</div><div><div>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.
The Senior Recruiter &ndash; Technology is responsible for leading full-cycle recruitment efforts for technology and IT professionals across a variety of disciplines, including Infrastructure, Cloud, Cybersecurity, Software Engineering, Data &amp; Analytics, Enterprise Applications, Architecture, and Digital Technology. This role serves as a strategic talent advisor to hiring leaders, developing and executing recruiting strategies to attract, assess, and hire top technical talent in a highly competitive market. The successful candidate will possess a strong background in technology recruiting, demonstrated success sourcing and hiring technical professionals, and the ability to consult with business leaders on talent market trends, candidate assessment, compensation, and workforce planning. 
Required Job Qualifications:
<ul><li>Bachelor&rsquo;s degree in Human Resources or Business and 4 years&rsquo; experience OR 8 years&rsquo; experience.</li><li>
Recruitment experience in recruitment agency or corporate environment.</li><li>
Experience with one or more applicant tracking systems and HRIS.</li><li>
Organizational, communication and problem-solving skills as well as sound judgment.</li><li>
Ability to establish priorities in a fast paced, multi-tasking environment.</li><li>
Ability to work with other departments within HR and collaborate effectively.</li><li>
Ability to recruit and work with hiring managers remotely.</li><li>
Ability to act as counselor to hiring managers and candidates on staffing and other HR related issues.</li><li>
Clear and concise interpersonal, verbal, and written communication skills.</li><li>
High energy level and willingness to do whatever is needed to get job done.</li></ul>
Preferred Job Qualifications:
<ul><li>6+ years of dedicated IT/Technology recruiting experience.</li><li>
Experience recruiting for Infrastructure, Cloud, Cybersecurity, Software Engineering, Architecture, Data &amp; Analytics, and IT leadership positions.</li><li>
Experience supporting hiring for Director, VP, or other senior-level technology leadership roles.</li><li>
Experience working with Workday Recruiting.</li><li>
Healthcare insurance, healthcare, or other highly regulated industry experience.</li><li>
Executive search or leadership recruiting experience.</li><li>
Experience conducting talent mapping, market intelligence, and workforce planning activities.</li><li>
Demonstrated strength presenting recruiting metrics, market insights, and hiring recommendations to senior leadership.</li></ul>
This is a Flex (Hybrid) role: 3 days in office; 2 days remote.
Compensation: $55,900.00 - $123,500.00
Exact compensation may vary based on skills, experience, and location
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. 
To learn more about available benefits, please visit https://careers.hcsc.com/totalrewards( opens in new window)</div></div></div>

Sr Recruiter

<div><div>Houston, TX Austin, TX Richardson, TX San Antonio, TX Full time 06/23/2026 R0052420 Compensation: $92,700.00 - $167,500.00
</div><div><div>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.
BASIC FUNCTION HCSC is looking for a dynamic individual to join its Provider Network management team! This position is responsible managing daily activities and implementation of strategies for provider recruitment and contracting of physicians, physician groups and facilities including large or complex groups/facilities (large independent hospital systems, integrated &amp; non-integrated systems, value based contracting, etc.). Will develop and negotiate contracts; develop and maintain relationships with providers and ensure strategic coverage for assigned territory. Role is responsible for education of providers and for ongoing provider service; will be responsible for the management, mentoring and training of a team responsible for provider contracting and provider support resources and 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. Neither relocation nor sponsorship (either now or in the future) will be extended. In-office visibility is required three days per week, working from home the other two days. NOTE: this is NOT an Information Technology or computer systems aligned role. #LI-TP1 #LI-hybrid 
JOB REQUIREMENTS<ul><li>
Bachelor&rsquo;s Degree and five (5) years of provider contracting experience OR 9 years&rsquo; of direct, managed care experience including five (5) years of provider contracting experience.</li><li>
Extensive knowledge of provider and facility contracting, products, and claims/processing systems.</li><li>
Leadership skills to oversee staff, implement initiatives, and work across the company to resolve issues.</li><li>
Solid negotiation skills.</li><li>
Strong relationship building skills.</li><li>
Extensive knowledge of the healthcare marketplace.</li><li>
Able to meet deadlines and work well under pressure.</li><li>
Excellent verbal and written communication skills to interact with all levels of corporate personnel and providers.</li><li>
PC proficiency to include Microsoft Office (Word, Excel, Outlook, PowerPoint).</li><li>
Keen analytical skills.</li><li>
Project management skills to lead or participate in projects or initiatives.</li><li>
Ability and willingness to travel within assigned areas of responsibility, including overnight stays.</li></ul>
PREFERRED JOB REQUIREMENTS<ul><li>
PMP Certification.</li><li><div>
HCISPP (Healthcare Information Security and Privacy Practitioner).</div></li><li>
Strong knowledge of hospital, professional physicians and ancillary.</li><li>
Salesforce acumen.</li></ul>
~ KEY FUNCTIONS ~
1. Ensure assigned staff performs according to established standards. Assign duties, monitor results, control budget, and appraise performance and direct staff as appropriate. 
2. Management duties include but are not limited to: hiring, performance management, pay administration, change management, talent management, and maintain knowledge of corporate, divisional and Human Resources policies, programs and systems. 
3. Work with internal departments to ensure appropriate implementation of executed agreements. 
4. Analyze financial reports to determine financial impact of negotiations. 
5. Develop and negotiate agreements with providers and facilities (including large independent hospital systems, integrated &amp; non-integrated systems, value based contracting, etc.) within assigned territory of responsibility. 
6. Responsible for maintaining a professional relationship with key provider groups. Ensure effective liaison and rapport is developed and maintained through meetings, correspondence and telephone calls. 
7. Ensure strategic objectives are being met with regard to physicians, physician groups and facilities needed for assigned territory(s). Ensure appropriate provider services including working across departments to resolve issues. Meet/exceed service goals. 
8. Oversee the servicing of facilities, large groups, and/or capitated entities to include assisting with eligibility and capitation issues, contracting issues, and bonus arrangements. Serves as a liaison between internal departments and the capitated entity. 
9. Work with delegated entities to ensure that providers are loaded correctly. 
10. Work closely with the delegation oversight department regarding the delegated entity reporting requirements to include claims delegation, utilization management delegation and credentialing delegation. 
11. Respond to provider inquiries in an effective and timely manner and assist in claims resolution and payment problems. 
12. Must work closely with the Pricing, Full Service Units, Utilization Management, Medical, Delegation Oversight, Core Credentialing, Provider Automation and other divisions within the company. 
13. Provide leadership regarding negotiation of rates for traditional and managed care business. Conduct and assist in the negotiation process and assure that providers are kept informed of pertinent changes in policies and procedures. 
14. Coordinate appropriate education/in-servicing is provided for providers. Education may pertain to managed care and areas where pertinent rulings/regulations could affect business. 
15. Explain corporate policies and procedures to contracted providers; counsel with provider&rsquo;s staff to ensure their familiarity with Blue Cross procedures. 
16. Establish and maintain relationships with assigned providers through personal visits, correspondence and telephone calls. 
17. Coordinate and direct the activities of the provider network staff. 
18. Serve as a mentor/teacher regarding the activities of staff. 
19. Monitor various reports, team activities and results regarding team performance objectives. 
20. Ensure the establishment and maintenance of an appropriate team focus. 
21. Serve on local and corporate committees and task forces that require input from Network Management Department. Participate in trade association meetings, as required. 
22. Transform fee for service contracts to fee for value. 
23. Develop reports and analyze performance outcomes. 
24. Ensure all expenditures comply with corporate and divisional expense guidelines. 
25. Other duties as assigned. 
26. Communicate and interact effectively and professionally with co-workers, management, customers, etc. 
27. Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies. 
28. Maintain complete confidentiality of company business. 
29. Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.
Compensation: $92,700.00 - $167,500.00
Exact compensation may vary based on skills, experience, and location
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. 
To learn more about available benefits, please visit https://careers.hcsc.com/totalrewards (opens in new window)</div></div></div>

Manager Network Management (Healthcare)

<div><div>Nashville, TN Chicago, IL Richardson, TX Full time 06/23/2026 R0048200 Compensation: $61,500.00 - $136,100.00
</div><div><div>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.
The IT Disaster Recovery Specialist is responsible for supporting the development, implementation, testing, and maintenance of disaster recovery (DR) plans to ensure systems, applications, and infrastructure can be restored effectively following outages or major disruptions. This role partners with IT teams to improve system recoverability, reduce downtime, and strengthen overall resilience. 
NOTE:This hybrid role can be located in CHICAGO IL, NASHVILLE,TNor RICHARDSON, TX ~ relocation will not be offered; sponsorship is not available; including if you are on OPT.
<div>Required Job Qualifications: 
<ul><li>Bachelor Degree and 2 years experience in disaster recovery planning, process analysis, and general business systems analyst OR 6 years related military experience.</li></ul></div><ul><li>Assist in the development and maintenance of disaster recovery plans for centralized and distributed systems, applications, and infrastructure</li><li>Identify system risks, vulnerabilities, and single points of failure, and recommend mitigation solutions</li><li>Develop, document, and maintain disaster recovery procedures, standards, and supporting materials</li><li>Coordinate and support disaster recovery testing activities, including recovery exercises and failover testing with IT teams</li><li>Document test results, track remediation activities, and support the resolution of identified gaps</li><li>Participate in recovery efforts during system disruptions by executing disaster recovery procedures as needed</li><li>Collaborate with infrastructure, application, and network teams to ensure recovery requirements and dependencies are clearly defined</li><li>Assist in evaluating third-party vendors to ensure disaster recovery capabilities and service level agreements (SLAs) align with organizational requirements</li><li>Maintain accurate documentation of system dependencies, recovery processes, and defined recovery objectives (RTOs and RPOs)</li></ul><div> 
Preferred Job Qualifications: 
<ul><li>Bachelor Degree in Computer Science, Information Systems, or other related field.</li></ul></div>
Key Responsibilities<ul><li>Assist in the development and maintenance of disaster recovery plans for centralized and distributed systems, applications, and infrastructure</li><li>Identify system risks, vulnerabilities, and single points of failure, and recommend mitigation solutions</li><li>Develop, document, and maintain disaster recovery procedures, standards, and supporting materials</li><li>Coordinate and support disaster recovery testing activities, including recovery exercises and failover testing with IT teams</li><li>Document test results, track remediation activities, and support the resolution of identified gaps</li><li>Participate in recovery efforts during system disruptions by executing disaster recovery procedures as needed</li><li>Collaborate with infrastructure, application, and network teams to ensure recovery requirements and dependencies are clearly defined</li><li>Assist in evaluating third-party vendors to ensure disaster recovery capabilities and service level agreements (SLAs) align with organizational requirements</li><li>Maintain accurate documentation of system dependencies, recovery processes, and defined recovery objectives (RTOs and RPOs)</li></ul>
#LI-BS1
#LI-Hybrid
#INCR
Compensation: $61,500.00 - $136,100.00
Exact compensation may vary based on skills, experience, and location
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. 
To learn more about available benefits, please visit https://careers.hcsc.com/totalrewards (opens in new window)</div></div></div>

Disaster Recovery Specialist - Infrastructure

<div><div>Chicago, IL Richardson, TX Full time 06/12/2026 R0051662 Compensation: $61,500.00 - $136,100.00
</div><div><div>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 position is responsible for creating and overseeing the development and implementation of successful marketing communications plans for segments of our product portfolio for B2B and B2C audiences. In this role you will write and proofread for a variety of audiences and media (digital, print, video, social media etc.), strong project management experience, multitasking skills, ability to develop and maintain positive working relationships with a variety of business partners, analytical skills to determine campaign success and areas for improvement. The successful candidate will have strong organization skills, be comfortable adapting to change and ability to navigate large highly matrixed work environment. 
Required Job Qualifications:<ul><li>
Bachelor&rsquo;s degree and 7 years&rsquo; experience in communications environment OR 11 years marketing, journalism, or communications experience.</li><li>
Knowledge of design, layout, and print production.</li><li>
Project management skills.</li><li>
Writing and verbal communications and editing skills.</li><li>
Independent, self-starter, ability to handle multiple projects simultaneously.</li></ul> 
Preferred Job Qualifications:<ul><li>
Bachelor&rsquo;s degree in communications.</li><li>
Experience with project management and/or proofing software.</li><li>
Copilot or other AI familiarity.</li></ul>
This is a Flex (Hybrid) role: 3 days in office; 2 days remote.
#LI-AS1
#LI-Hybrid
INJLF
Compensation: $61,500.00 - $136,100.00
Exact compensation may vary based on skills, experience, and location
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. 
To learn more about available benefits, please visit https://careers.hcsc.com/totalrewards (opens in new window)</div></div></div>

Lead Marketing Communications Consultant