Cost of Care Analyst role at Elevance Health applying advanced analytics to drive healthcare insights and innovations. Requires strong quantitative skills and experience in healthcare analytics.
Responsibilities
Provides analytical insights to support business solution development based on quality, use, cost, and other key drivers
Develops and refines analysis templates for problem diagnosis and opportunities assessment
Consults on all considerations related to designing and executing tests or pilot programs
Contributes to the design of new programs/initiatives based on test/pilot outcomes
Develops targeting criteria or customer segmentation based on analytical insights, clinical inputs, product design, and operations considerations
Develops predictive models and other tools that help target the right members
Develops methodology to measure clinical, utilization, and financial outcomes of a program/initiative
Conducts in-depth research to address challenging issues in measuring outcomes
Leads applied research projects
Authors white papers, presents at industry conferences, and submits journal publications
Addresses the limitation of certain data sources and evaluates the incremental value of new data sources
Requirements
Requires MS, MA, or PhD with concentration in a quantitative discipline such as Mathematics, Statistics, Economics, Epidemiology, Engineering, Computer Science or Operations Research
a minimum of 5 years experience in related health care analytics
Experience performing trend analysis to identify patterns in healthcare costs over time
In-depth understanding of healthcare dynamics, including service delivery, reimbursement models, and payer systems
Experience in healthcare finance or healthcare actuarial analytics
Substantial analytical experience in the healthcare industry
Advanced SQL & SAS skills
Oracle Exadata experience preferred
Familiarity with AI/ML frameworks
Additional skills for success are Python, Informatica, Tableau, and/or Power BI
Experience in using Agile estimation techniques such as Planning Poker, T-shirt Sizing, or the Fibonacci sequence
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