Provider Contract / Cost of Care Analyst Sr. - SQL / Healthcare

Company: Elevance Health
Location: Louisville
Posted on: September 16, 2023

Job Description:

WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Elevance Health requires a completed online application for consideration of employment for any position. We will never ask you for a credit card, send you a check, or ask you for payment as part of consideration for employment. **Provider Contract / Cost of Care Analyst Sr. - SQL / Healthcare** + Job Family: Analytics + Type: Full time + Date Posted:Sep 07, 2023 + Req #: JR85834 **Location:** + Georgia, Atlanta + Georgia, Midland + Colorado, Denver + Washington, Seattle + Minnesota, Mendota Heights + Louisiana, Metairie + Minnesota, Gilbert + New York, Middletown + Ohio, Seven Hills + New Jersey, Iselin + California, Woodland Hills + Ohio, Mason + New York, Latham + California, Walnut Creek + Kentucky, Louisville + Ohio, Columbus + Tennessee, Nashville + Ohio, Cincinnati + Indiana, Indianapolis + Rhode Island, Smithfield + Florida, Tampa + North Carolina, Winston + New Hampshire, Manchester + District of Columbia, Washington + California, Costa Mesa + Delaware, Wilmington + Iowa, West Des Moines + Nevada, Las Vegas + Connecticut, Wallingford + Virginia, Roanoke + Texas, Houston + Virginia, Richmond + Nebraska, Lincoln + Texas, Grand Prairie + Illinois, Chicago + Wisconsin, Waukesha + North Carolina, Cary + Missouri, St. Louis + Maryland, Hanover + Florida, Miami + Virginia, Norfolk + Maine, South Portland + West Virginia, Charleston + New Jersey, Morristown **Description** Provider Contract / Cost of Care Analyst Sr. - Requires SQL (JR85834) **Location** : Will consider candidates who reside within 50 miles/1 hour commute each way of a relevant Elevance Health location. **Note:** Requires 1 day per week in office. The **Enterprise Cost of Care team** enables Elevance Healths focus on quality while reducing medical spend and overall costs to our member population and the health care system as a whole. By working with cross-functional teams to identify and execute practical cost of care strategies and initiatives, the team drives greater affordability and value for Elevance Health. The **Provider Contract / Cost of Care Analyst Sr** 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. Primary duties may include, but are not limited to: + 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. + 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 Requirements** + 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 Qualifications** + Proficient creating SQL queries to create and manage large data sets. + Experience manipulating large datasets and creating data models using Excel. For candidates working in person or remotely in the below locations, the salary* range for this specific position is $73,668 to $126,288. Locations: California; Colorado; Nevada; New York; Washington State; Jersey City, NJ. In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws _._ * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Companys sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. **Be part of an Extraordinary Team** Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact? 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, providing various levels of flexibility while also ensuring that associates have opportunities to connect in-person. Unless in a designated virtual-eligible role and 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 and Elevance Health approves a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health has been named as a Fortune Great Place To Work in 2022, has been ranked for five years running as one of the 2023 Worlds Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. 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 ability@icareerhelp.com for assistance. EEO is the Law Equal Opportunity Employer / Disability / Veteran Please use the links below to review statements of protection from discrimination under Federal law for job applicants and employees. + EEO Policy Statement + Know Your Rights + Pay Transparency + Privacy Notice for California Residents Elevance Health, Inc. is anE-verify Employer (https://www.e-verify.gov/sites/default/files/everify/posters/EVerifyParticipationPoster.pdf) Need Assistance? Email us (elevancehealth@icareerhelp.com) or call 1-877-204-7664

Keywords: Elevance Health, Louisville , Provider Contract / Cost of Care Analyst Sr. - SQL / Healthcare, IT / Software / Systems , Louisville, Kentucky