Director II Provider Economics – Value-Based Specialty Care

Location: This role requires associates to be in-office 3 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.

The Director II, Provider Economics, will lead strategic analytics and payment design initiatives that fuel our value-based care strategy across all lines of business. You’ll drive measurable improvements in provider performance, affordability, and patient outcomes by developing and optimizing data-driven reimbursement models, especially within the specialty care space.

How you will make an impact:

•    Develop, evaluate, and enhance value-based care models for specialty providers that align with Elevance Health’s enterprise payment strategy.
•    Use financial modeling and forecasting to support the design of new provider reimbursement methodologies across Medicare, Medicaid, and Commercial lines of business.
•    Measure and report on program performance to ensure value-based commitments are met and inform future roadmap design.
•    Oversee enterprise analytics teams to deliver actionable insights on provider economics, contract structures, and affordability strategies.
•    Leverage modeling tools to quantify financial and clinical impacts of existing and emerging payment models.
•    Drive continuous improvement of analytic strategies to support expansion and innovation in value-based care.
•    Serve as a trusted strategic partner to internal business leaders and senior executives, contributing to enterprise-level financial and network negotiations.
•    Represent Elevance Health’s financial position during direct interactions with provider groups and large health systems.
•    Collaborate with cross-functional teams including Actuarial, Clinical, Network, and Finance to drive shared goals.
•    Lead, coach, and develop a high-performing team of analysts and consultants.
•    Foster a culture of accountability, innovation, and data-driven decision-making.
•    Provide oversight of team operations, performance management, and workforce planning.

Minimum Requirements:
 

Requires a BA/BS degree in Business or related field and a minimum of 10 years of experience in broad-based analytical, managed care payor or provider environment as well as minimum of 5 years management experience in the healthcare industry or large multi-operational corporate environment; or any combination of education and experience, which would provide an equivalent background. Master’s degree strongly preferred.

Preferred Skills, Capabilities and Experiences:

•    Master’s degree in Health Economics, or a related field is strongly preferred.
•    Experience leading health economics teams with a focus on value-based care in specialty settings (e.g., oncology, cardiology, orthopedics, renal, or other unique population) is preferred.
•    Familiarity with attribution methodologies and performance-based program design is preferred.
•    Actuarial background or experience collaborating with actuarial teams is preferred. 
•    Experience working with risk models is preferred.
•    Deep understanding of provider contracting, quality metrics, and clinical integration strategies across all lines of business is preferred.

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.