Provider Contract/Cost of Care Sr job opportunity at Elevance Health.

Home Jobs In United States Of America Tag: Job Provider Contract/Cost of Care Sr position at Elevance Health


DatePosted 6 Days Ago bot
Elevance Health Provider Contract/Cost of Care Sr
Experience: 3-years
Pattern: full-time
Country:
apply Apply Now
Salary:
Status:

Job

Copy Link Report
degreeAssociate
loacation GA-ATLANTA, 740 W PEACHTREE ST NW, United States Of America
loacation GA-ATLANTA, 74..........United States Of America

Anticipated End Date: 2026-03-09 Position Title: Provider Contract/Cost of Care Sr Job Description: Provider Contract/Cost of Care Sr Locations: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. PLEASE NOTE: This position is not eligible for current or future VISA sponsorship. The Provider Contract/Cost of Care Sr provides analytical support to the Cost of Care 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 which may include: developing moderately complex ROI models and performs healthcare cost analysis to identify strategies to control costs; projecting 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; performing modeling to compare various contract scenarios based on member utilization patterns and 'what if' logic; measuring and evaluating the cost impact of various negotiation proposals; researching the financial profitability/stability and competitive environment of providers to determine impact of proposed rates; and projecting 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. Participates on project team involved with enterprise wide initiatives. Minimum Requirements: Requires 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, Experiences and Competencies: Healthcare Industry highly preferred. High proficiency in SQL and Excel Data analytics within healthcare industry Exposure to Python or R Master's degree preferred. Job Level: Non-Management Exempt Workshift: 1st Shift (United States of America) Job Family: RDA > Health Economics & Cost of Care 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration .

Other Ai Matches

Pharmacy Technician I – Data Entry -BioPlus Specialty Pharmacy Applicants are expected to have a solid experience in handling Job related tasks
Triage RN - Virtual - Overnight - CareBridge Applicants are expected to have a solid experience in handling Job related tasks
IT Quality Control Test Architect Applicants are expected to have a solid experience in handling Job related tasks
Manager I Customer Care - Multi Applicants are expected to have a solid experience in handling Job related tasks
Solutions Engineer Advisor Sr Applicants are expected to have a solid experience in handling Job related tasks
Authorization Representative I Applicants are expected to have a solid experience in handling Job related tasks
Engineer Senior Applicants are expected to have a solid experience in handling Job related tasks
Value Based Care Consultant Sr. (Provider Success) (Washington State) Applicants are expected to have a solid experience in handling Job related tasks
Onsite Health Coach Applicants are expected to have a solid experience in handling Job related tasks
Epic Interface Analyst Applicants are expected to have a solid experience in handling Job related tasks
Nurse Practitioner, Bilingual, 100% Virtual, CareBridge Applicants are expected to have a solid experience in handling Bilingual, 100% Virtual, CareBridge related tasks
Actuarial Analyst II Applicants are expected to have a solid experience in handling Job related tasks
Behavioral Health Medical Director – Psychiatrist - Louisiana Market Applicants are expected to have a solid experience in handling Job related tasks
Crisis & Referral Specialist - LA Applicants are expected to have a solid experience in handling Job related tasks
Transitions of Care RN- Carebridge Applicants are expected to have a solid experience in handling Job related tasks
Specialist Medical Director - Radiation Oncology Applicants are expected to have a solid experience in handling Job related tasks
Outreach Care Specialist - Pasco/ Pinellas County Applicants are expected to have a solid experience in handling Job related tasks
Nutritional Consultant Applicants are expected to have a solid experience in handling Job related tasks
Nurse Case Mgr I Applicants are expected to have a solid experience in handling Job related tasks
Director II Medicaid State Operations-Indiana State Health Plan Applicants are expected to have a solid experience in handling Job related tasks
LTSS Service Coordinator-Clinician (Jackson/Columbus) Applicants are expected to have a solid experience in handling Job related tasks
Investigator Assistant Applicants are expected to have a solid experience in handling Job related tasks
Regional Account Liaison - BioPlus Specialty Pharmacy (Greater Boston Territory) Applicants are expected to have a solid experience in handling Job related tasks