PROVIDER CONTRACT/COST OF CARE ANALYST SR
Company: Elevance Health
Location: Norfolk
Posted on: October 16, 2024
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Job Description:
Provider Contract/Cost of Care Analyst Sr.Location: This
position will work a hybrid model (remote and in office 1 - 2 days
per week). Candidates must live within 50 miles of one of
Elevance's Pulse Point locations.The Provider Contract/Cost of Care
Analyst Sr. is responsible for analytical support to the Cost of
Care and/or Provider Contracting organizations. Focuses efforts on
lowering claims costs, improving the quality of care, and
increasing member and provider network satisfaction. Typically
works with one provider type, e.g. physician, ancillary, or medical
group. Provides advice and analytic support to Medical Directors,
contract negotiators and management on cost of care issues to help
reduce costs without compromising quality of care.How you will make
an impact:--- Performs varied data analyses--- Develops moderately
complex ROI models and performs healthcare cost analysis to
identify strategies to control costs--- Projects cost increases in
medical services by using analytic techniques for PMPM trending via
multiple variable analysis--- Preparing pre-negotiation analyses to
support development of defensible pricing strategies Performs
modeling to compare various contract scenarios based on member
utilization patterns and 'what if' logic--- Measures and evaluates
the cost impact of various negotiation proposals;--- Researches the
financial profitability/stability and competitive environment of
providers to determine impact of proposed rates--- Projects
different cost of savings targets based upon various analytics.---
Identifies cost of care savings opportunities by analyzing practice
patterns in relation to office visits, referral practices, and
specialty care procedures and 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.Minimum RequirementsRequires 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 as well as 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:---
Master's degree preferred.--- Proficiency in SQL or SAS
preferred--- Proficiency in Microsoft Excel/Access preferred---
Ability to work well with others preferredPlease 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 AreElevance 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
WorkAt 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.
Keywords: Elevance Health, Suffolk , PROVIDER CONTRACT/COST OF CARE ANALYST SR, Professions , Norfolk, Virginia
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