Provider Contract/Cost of Care Consultant Senior
4 weeks ago
Provider Contract/Cost of Care Consultant Senior-Analytics
Location: This position will work a hybrid model (remote and office). Must live within 50 miles/1 hour commute of one of our Elevance Health locations.
The Extended Value Analytics and Optimization team is looking for a senior analyst who will lead medical cost trend deep dives to uncover root-cause trend drivers and support initiative design for remediation. The Provider/Cost of Care Consultant Senior will mine data at a detailed level to identify Cost of Care opportunities, build opportunity analyses to support size and scope understanding, and collaborate with key business leaders to develop innovative solutions and drive value.
How you will make an impact:
Provides analytical support to the Cost of Care and/or Provider Contracting organizations.
Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider network satisfaction.
Provides advice, analytic and consultative support to Medical Directors and management on cost of care issues.
Works and acts a project lead on large scale and complex enterprise-wide initiatives with high dollar cost savings opportunities.
Uses analytic tools to perform sophisticated retrospective data analytics; building new and modifying existing complex models to create predictive impact decision making tools; performing healthcare cost analysis to identify strategies to control costs; projecting cost increases in medical services by using analytic techniques for PMPM trending via multiple variable analysis; preparing 'what if' logic; measuring and evaluating the cost impact of various interventions; and projects different cost of savings targets based upon various analytics.
Identifies cost of care savings opportunities by analyzing practice patterns in relation to office visits, referral practices, and specialty care procedures.
Recommends policy changes and claim's system changes to pursue cost savings.
Reviews results post-implementation to ensure projected cost savings are realized and recommends modifications as applicable.
Recommends standardized practices to optimize cost of care.
Looks for continuous quality improvements and finds better ways to accomplish end results.
Acts as a strategic partner to management.
- Requires BA/BS degree in Mathematics, Statistics or related field and a minimum of 7 years experience in broad-based analytical, managed care payor or provider environment as well as in depth experience in statistical analysis and modeling; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
Experience providing leadership in evaluating and analyzing complex initiatives strongly preferred.
Master's degree preferred.
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $102,640 to $184,752.
Locations: California; Colorado; Hawaii; New York; Nevada, Washington State; Jersey City, NJ
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
*The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
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