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Cost of Care Mgr (US)

  • Job Family: PND > Network Contracting
  • Type: Full time
  • Date Posted:
  • Anticipated End Date:
  • Reference: JR111026

Location:

  • Indiana
  • North Carolina
  • Texas
  • Wisconsin
  • Michigan
  • Nevada
  • Virginia
  • Colorado
  • Ohio
  • Kentucky
  • Connecticut
  • California
  • Maine
  • New Hampshire

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Description

The Cost of Care Mgr leads and manages multiple cost of care initiatives enterprise wide (e.g. local, within each state, across business segments and at the enterprise level) and drives their execution. Understands, predicts and implements measures to control healthcare costs and to make healthcare more affordable for our customers. Develops, manages, oversees, and executes new and innovative initiatives to manage rising costs and enhance the company's market competiveness. Primary duties may include, but are not limited to:

  • Identifies and develops best practices and cost of care improvement processes around physician, hospital and ancillary network contract negotiation strategies, utilization management efforts, new products, annual benefit design participation, and financial operations.
  • Oversees the identification of potential cost of care savings opportunities through complex analytics via partnering with the cost of care analytics team, to developing action plans, benefits and risk assessments and overseeing and partnering with the actuarial team to develop and ensure accurate savings quantification.
  • Champions cost of care initiatives, negotiates for human capital resources, and partners with care management, claims, IT, and business partners.
  • Manages and presents cost of care projects to senior leadership including State Plan Presidents.
  • Serves on local and enterprise committees.
  • Plans, leads and oversees cost of care planning meetings and tracks and reports on cost of care projects.
  • May map disparate sources of data to a common language for analysis.
  • May work on projects as assigned.

Requirements:

  • a BS/BA degree and minimum of 5 years relevant experience in Health Care; or any combination of education and experience, which would provide an equivalent background.
  • Strongly preferred Financial, Business, and Leadership acumen.
  • 2 years experience in broad-based analytical, managed care payor or provider environment as well as experience in statistical analysis and healthcare modeling preferred.
  • MBA, MHA, MA preferred.
  • PMP or Six Sigma Green Belt preferred.
  • Prior experience with provider network contracting, provider networks, claims, finance, and operations preferred.
  • SQL experience preferred.

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $83,280.00 - $104,100.00.

Locations:  California; Colorado; Hawaii; 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 Company’s sole discretion, consistent with the law.


 

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. 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 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.comfor assistance.

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