Senior Provider Contract Cost of Care Analyst

4 weeks ago

Mason, United States Elevance Health Full time
Job Summary

We are seeking a highly skilled Senior Provider Contract Cost of Care Analyst to join our team at Elevance Health. As a key member of our Cost of Care and Provider Contracting organizations, you will provide analytical support to drive business growth and improve member and provider network satisfaction.

Key Responsibilities
  • Perform data analyses to identify strategies to control costs and improve quality of care.
  • Develop and implement ROI models to project cost increases in medical services.
  • Prepare pre-negotiation analyses to support development of defensible pricing strategies.
  • Measure and evaluate the cost impact of various negotiation proposals.
  • Research the financial profitability/stability and competitive environment of providers to determine impact of proposed rates.
  • Project different cost of savings targets based upon various analytics.
  • Identify cost of care savings opportunities by analyzing practice patterns in relation to office visits, referral practices, and specialty care procedures.
  • Recommend policy changes and claim's system changes to pursue cost savings.
  • Review results post-implementation to ensure projected cost savings are realized and recommend modifications as applicable.
  • Recommend standardized practices to optimize cost of care.
  • Educate provider contractors on contracting analytics from a financial impact perspective.
  • Recommend alternative contract language and may go on-site to provider premises during contract negotiations.
  • Participate on project team involved with enterprise-wide initiatives.
Requirements
  • Requires BS/BA degree in Mathematics, Statistics, or related field and a minimum of 3 years' experience in broad-based analytical, managed care payor or provider environment as well as experience in statistical analysis and healthcare modeling.
  • Previous health insurance experience strongly preferred.
  • Client-facing experience strongly preferred.
  • Strong communication skills preferred.
  • Quick learner and an effective team player preferred.
  • Master's degree preferred.
  • SAS, SQL, PowerPoint, Tableau, Power BI and Excel preferred.
About Elevance Health

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.

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.

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 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.

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