Healthcare Cost Analyst Senior

4 weeks ago


Woburn, Massachusetts, United States Elevance Health Full time
Senior Provider Contract Cost of Care Analyst Role

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.
Requirements:
  • 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.
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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