Healthcare Cost Analyst Senior
7 hours ago
Elevance Health is seeking a seasoned Senior Provider Contract Cost of Care Analyst to join our team. This critical role will provide analytical support to our Cost of Care and/or Provider Contracting organizations, focusing on lowering claims costs, improving quality of care, and increasing member and provider network satisfaction.
Key Responsibilities:- Perform varied data analyses, including developing moderately complex ROI models, to identify strategies to control costs.
- Project cost increases in medical services by using analytic techniques for PMPM trending via multiple variable analysis.
- Prepare pre-negotiation analyses to support development of defensible pricing strategies.
- Model various contract scenarios based on member utilization patterns and 'what if' logic.
- Measure and evaluate the cost impact of various negotiation proposals.
- Research the financial profitability/stability and competitive environment of providers to determine the 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.
- Requires a 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; or any combination of education and experience which would provide an equivalent background.
- Previous health insurance experience strongly preferred.
- Client-facing experience strongly preferred.
- Strong communication skills preferred.
- Quick learner and an effective team player preferred.
- SAS, SQL, PowerPoint, Tableau, Power BI, and Excel preferred.
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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