Provider Contract/Cost of Care Consultant

Provider Contract Cost of Care Consultant

Location : This position will work a hybrid model (remote and in office one day per week). Ideal candidates will live within 50 miles of one of our Pulse Point locations in Norfolk, VA, Richmond, VA Indianapolis, IN, Atlanta, GA, Mason, OH, Cincinnati, OH, Tampa, FL or Chicago, IL.

The Provider Contract Cost of Care Consultant provides analytic support to the Finance, Clinical, Cost of Care and Enterprise organizations focusing efforts on explaining medical cost trends, lowering claims costs, and improving the quality of care.

How you will make an impact:

Provide analytic and consultative support on cost of care issues and medical cost trends.

Collaborate across multiple business groups to ensure that financial analyses reflect appropriate business considerations and assumptions.

Work closely with internal business partners providing analyses and helping them understand the risks and impacts of medical policy decisions and other cost of care concepts.

Analyze and present data related to medical trends.

Summarize performance using appropriate analytics and tools.

Develop business performance reports using claims data that tells the drivers behind medical trends.

Create and publish standard and ad hoc reports.

Perform healthcare cost and trend analysis to identify strategies to control costs.

Execute analyses including retrospective data analytics uncovering drivers related to providers, diagnoses, product, and member mix among other many other variables.

Identify cost of care savings opportunities by analyzing practice patterns.

Collaborate with other teams by contributing with analyses and acting as a consultant.

Develop an in-depth understanding of line of business concerns to facilitate novel ways of exploring and explaining trends.

Provide input and consultative support to Medical Directors, Finance Leaders, and Business Unit Leaders on trend and cost of care issues.

Present analytic projects during workgroup calls and explain analyses to a diverse audience.

Participate on project teams involved in regional and enterprise-wide initiatives.

Minimum Requirements:

Requires BS/BA degree in Mathematics, Statistics, or related field; minimum of 5 years’ experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical analysis and healthcare modeling; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

Background in Healthcare Economics strongly preferred.

Experience with SQL, MS Excel and MS PowerPoint strongly preferred.

Ability to write SQL queries strongly preferred.

Experience manipulating large relationship databases strongly preferred.

Masters degree preferred.

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.