The Healthcare Economics Consultant/Cost of Care provides analytic support to the Finance, Clinical, Cost of Care and Enterprise organization focusing efforts on explaining medical cost trends, lowering claims costs, and improving the quality of care. Provide analytic and consultative support on cost of care issues and medical cost trends. Collaborate across multiple business groups to ensure that financial analyses reflect appropriate business considerations and assumptions. Work closely with internal business partners providing analyses and helping them understand the risks and impacts of medical policy decisions and other cost of care concepts. This is not a Contracting Analytics position.
How you will make an impact:
- Analyze and present data related to medical trends. Summarize performance using appropriate analytics and tools. Develop business performance reports using claims data that tells the drivers behind medical trends. Create and publish standard and ad hoc reports.
- Develop an in-depth understanding of line of business concerns to facilitate novel ways of exploring and explaining trends.
- Provide input and consultative support to Medical Directors, Finance Leaders, and Business Unit leaders on trend and cost of care issues.
- Build new and modify existing complex models to create predictive impact decision making tools; Perform healthcare cost analysis to identify strategies to control costs.
- Project cost increases in medical services by using analytic techniques for PMPM trending via multiple variable analysis.
- Identify cost of care savings opportunities by analyzing practice patterns in relation to office visits, referral practices, and specialty care procedures.
- Recommend policy changes and claim system changes to pursue cost savings.
- Review results post-implementation to ensure projected cost savings are realized and recommends modifications as applicable.
- Recommend standardized practices to optimize cost of care.
- Participate on project teams involved with enterprise-wide initiatives.
- Acts as a source of direction, training, and guidance for less experienced staff.
BS/BA degree in Mathematics, Statistics, or related field; minimum of 5 years’ experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical analysis and healthcare modeling; or any combination of education and experience, which would provide an equivalent background.
Assets and preferred qualifications:
SQL or SAS experience required
Advanced Excel skills required
Experience with healthcare data required (Medicare data preferred)
Experience in statistical analysis and healthcare modeling.
Experience manipulating large data sets.
Experience providing leadership in evaluating and analyzing complex initiatives.
Value-Based Contract experience
Healthcare economics knowledge
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.
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 World’s 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 email@example.com for assistance.