Title : Care Consultant Sr.
Location : Maryland with up to 25% travel time.
Hours : Standard
Build the possibilities. Make an extraordinary impact:
The Care Consultant Sr. is responsible for consulting with providers to improve the effectiveness and efficiencies of provider practices participating in Elevance Health’s alternative payment models. Support will be provided across all LOBs (Medicare, Medicaid and Commercial), and a variety of reimbursement and value-based care programs. The Care Consultant Sr. will work closely with the Account Manager, provider enablement and clinical subject matter experts to drive quality improvement and specific cost and utilization metrics.
How you will make an impact:
- Exhibit an experienced level of consulting competencies to drive recommendations and actions with providers and practice teams on office based care delivery interventions resulting in cost of care savings and improved health outcomes for patients.
- Obtains and analyzes practice specific cost and quality data and reports for cost of care and quality opportunities, supports practice to target high risk Elevance Health members and gaps in care, supports practice implementation of population health management, care coordination and care management strategies, identifies action plans for providers to implement to improve cost, quality and the patient experience and participates in design, development, and implementation of community learning forums.
- Serves as liaison with Elevance Health Care Management to facilitate clinical processes between the company and the provider office.
- Conduct assessments and provide recommendations for provider enablement opportunities.
- Promote practice transformation to team-based patient centered care delivery.
- Provide education for practices to develop expertise with metrics and data review for quality improvement.
- Track progress of program and prepares status reports to management or senior management.
- Interact and lead large meetings with practice staff including physicians, clinical and administrative staff.
- Identifies opportunities and recommendations to support the deployment of program interventions and action plans.
- Collaborates with EPHC team and other program stakeholders, including but not limited to: Account Manager, Provider Enablement, and other internal departments to collectively support the provider in their Value Based Contract.
- Requires a BA/BS and minimum of 5 years health care experience; or any combination of education and experience, which would provide an equivalent background.
- Physician environment experience in practice transformation/quality improvement, ambulatory care setting quality and efficiency metrics, population health and care management structures, data analytics and electronic health records preferred.
- Clinical background and/or MBA not required but a plus.
Preferred Skills, Capabilities and Experiences:
- Previous experience with multiple lines of business (Medicaid, Medicare and Commercial) is highly preferred.
- Understanding of value-based payment models, population management and care delivery concepts is highly preferred.
- Strong financial analysis skills highly preferred.
- Proficient in presenting technical and strategic information to multiple levels of internal and external stakeholders and excellent communication skills.
- Ability to be self-motivated and think outside the box to reach goals is highly desirable.
- Organized, self-starter with attention to both big picture goals and details is highly desirable.
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. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.
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.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates 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 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. 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 firstname.lastname@example.org for assistance.