Hybrid Provider Contract Cost of Care Consultant

at Elevance Health

• Job title: Provider Contract Cost of Care Consultant
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: Not specified
• Degree requirement: Bachelor's Degree
• Tech skills: SQL, Tableau
• Location requirements: Hybrid, Indianapolis, United States

About the role

• Provider Contract Cost of Care Consultant providing analytical support to improve healthcare costs and provider relations. Requires extensive experience in analytics and healthcare modeling in a hybrid environment.

Responsibilities

• Provides expert advice, analytic and consultative support to Medical Directors and management on cost of care issues
• Works on large scale initiatives with high dollar cost savings opportunities
• Partners with provider contractors to develop contracting strategy and supports all aspects of the contract negotiation process
• Can work with multiple provider types, e.g. physician, ancillary, medical groups, or hospitals
• Supports a full range of contract arrangements and pricing mechanisms
• Works on complex enterprise-wide initiatives and acts as project lead
• Uses analytic tools to track both health risks and compliance, as well as supporting the contract negotiation process
• Types of analyses include performing sophisticated retrospective data analytics; building new and modifying existing complex models to create predictive impact decision making tools
• Recommends policy changes and claim's system changes to pursue cost savings
• Reviews results post-implementation to ensure projected cost savings are realized and recommends modifications as applicable
• Recommends standardized practices to optimize cost of care
• Educates provider contractors on contracting analytics from a financial impact perspective
• May recommend alternative contract language and may go on-site to provider premises during contract negotiations
• Participates on project team involved with enterprise wide initiatives
• Acts as a source of direction, training and guidance for less experienced staff

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
• Master's degree preferred
• Proficiency with Snowflake, SAS, SQL and Excel is strongly preferred
• Experience with Tableau is preferred
• Experience with Value-based programs preferred
• Health Economics background strongly preferred
• Healthcare background strongly preferred

Benefits

• merit increases
• paid holidays
• Paid Time Off
• incentive bonus programs
• medical
• dental
• vision
• short and long term disability benefits
• 401(k) +match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources