Provider Cost of Care Analyst Senior
| Company | Elevance Health |
|---|---|
| Location | Indianapolis, IN, USA, Louisville, KY, USA, Richmond, VA, USA, St. Louis, MO, USA, Mason, OH, USA, Atlanta, GA, USA, Cincinnati, OH, USA |
| Salary | $Not Provided – $Not Provided |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Senior |
Requirements
- Requires BS/BA degree in Mathematics, Statistics, or related field
- Minimum of 3 years experience in broad-based analytical, managed care payor or provider environment
- Experience in statistical analysis and healthcare modeling
Responsibilities
- 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
- Performs varied data analyses which may include: developing moderately complex ROI models and performs healthcare cost analysis to identify strategies to control costs
- Identifies cost of care savings opportunities by analyzing practice patterns in relation to office visits, referral practices, and specialty care procedures
- 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
Preferred Qualifications
- Master’s degree preferred