Senior Provider Contract Analyst

1 day ago


Grand Prairie, Texas, United States Elevance Health Full time
About the Role

We are seeking a highly skilled Senior Provider Contract Analyst to join our team at Elevance Health. As a key member of our Cost of Care organization, you will play a critical role in analyzing and negotiating contracts with healthcare providers to ensure the best possible outcomes for our members.

Key Responsibilities
  • Provide analytical support to the Cost of Care and Provider Contracting organizations, focusing on lowering claims costs, improving quality of care, and increasing member and provider network satisfaction.
  • Work closely with the contracting team to build, maintain, and update fee schedules related to our provider contracts.
  • Perform varied data analyses, including developing complex ROI models and healthcare cost analysis to identify strategies to control costs.
  • Identify cost of care savings opportunities by analyzing practice patterns and recommending policy changes and claims 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 and educate provider contractors on contracting analytics from a financial impact perspective.
  • Participate on project teams involved with enterprise-wide initiatives.
Requirements
  • 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.
  • Experience in statistical analysis and healthcare modeling.
  • Master's degree preferred.
  • High level mastery of Excel preferred.
  • Minimum of 2 years' experience with SQL coding preferred.
  • SAS, Teradata experience 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.



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