Anticipated End Date:

Position Title:

Job Description:

Provider Contract/Cost of Care Analyst Senior

Location: This role requires associates to be in-office 1 day 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. Ideal candidates will be able to report our Pulse Point location in Atlanta, GA. Alternate locations may be considered if candidatesresidewithin 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, unlessan accommodationis granted as required by law.

The Provider Contract/Cost of Care Analyst Senior provides 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 which includes developing 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.

• Prepares 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.

• Recommends alternative contract language and may go on-site to provider premises during contract negotiations.

• Participates on project team involved with enterprise-wide initiatives.

MinimumRequirements:

Requires BS/BA degree in Mathematics, Statistics, or related field and a minimum of 3 years of 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.

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Workshift:

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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.