Status: Work from home, Full-time, Salaried with annual bonus potential
Willing to consider locations other than those listed for the right candidate
The Director Provider Economics directs the development of negotiation impact analysis in support of provider negotiations and physician fee schedule development and provides expert advice and analytic support to executive management on cost of care issues and opportunities within a functional area or geographic region.
Primary duties may include, but not limited to:
• Prepares healthcare cost analysis to identify new, innovative strategies to control costs.
• Performs complex fee modeling exercises.
• Manage team performing financial reconciliation of value based contracts including risk arrangements
• Communicates fee strategies both internally and externally to manage provider expectations. Prepares negotiation prep analysis to support development of negotiation strategy.
• Evaluates cost impact of various negotiation proposals.
• Provides analytic support during complex provider negotiations.
• Provides day to day negotiation support for national ancillary providers (lab, dialysis, etc).
• Hires, trains, coaches, counsels, and evaluates performance of direct reports.
BA/BS degree in Business or related field; 5+ years’ experience in broad-based analytical, managed care payor or provider environment; or any combination of education and experience, which would provide an equivalent background.
Experience in statistical analysis strongly preferred.
CPA or MBA preferred.
Additional Ideal Experience:
• 5 years’ experience with Medicaid Managed Care Program
• 5 years’ experience with Medicare Advantage including premium and risk score analytics
• 3 years of value-based contracting analytics and VBC financial reconciliations
• Experience with Medical Loss Ratio based risk contracting
• 3 years’ experience with restated financials and provider cost trend analytics
• Experience operating in matrix management environment and engaging stakeholders across multiple departments
For candidates working in person or remotely in Colorado, the salary* range for this specific position is $132,240-$198,360
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 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.