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Cost of Care Manager
2 months ago
2024-10-10
Position Title:
Cost of Care Manager - Healthcare Networks
Job Description:
Cost of Care Manager - Healthcare Networks (JR127712)
Location: This position requires you to reside within 50 miles of a relevant, open Elevance Health PulsePoint location AND as part of our Hybrid 1 Work Strategy, you are required to work from your local office location 1 - 2 days/week.
The Cost of Care Manager leads and manages multiple cost of care initiatives enterprise wide (e.g. local, within each state, across business segments and at the enterprise level) and drives their execution; works cross functionally with Health Economics, Pricing Configuration, Local Network, Actuarial & Others to identify potential savings tied OON & develops / drive tactics to realize & quantify those savings.
Understands, predicts and implements measures to control healthcare costs and to make healthcare more affordable for our customers. Develops, manages, oversees, and executes new and innovative initiatives to manage rising costs and enhance the company's market competitiveness. Primary duties may include, but are not limited to:
- Identifies and develops best practices and cost of care improvement processes around physician, hospital and ancillary network contract negotiation strategies, utilization management efforts, new products, annual benefit design participation, and financial operations.
- Oversees the identification of potential cost of care savings opportunities through complex analytics via partnering with the cost of care analytics team, to developing action plans, benefits and risk assessments and overseeing and partnering with the actuarial team to develop and ensure accurate savings quantification.
- Champions cost of care initiatives,
- Manages and presents cost of care projects to senior leadership.
Minimum Requirements:
- BS/BA degree and minimum of 5 years relevant experience in Health Care; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications:
- Prior experience with provider network contracting, provider networks, claims, finance, and operations.
- Financial, Business, and Leadership acumen with project management skills.
- MBA, MHA, MA preferred.
- PMP or Six Sigma Green Belt.
Job Level:
Non-Management Exempt
Workshift:
Job Family:
PND > Network Contracting
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
