*Travel may be required*
CARE CONSULTANT SR
Build the Possibilities. Make an extraordinary impact.
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 and 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. Conduct assessments and provide recommendations for provider enablement opportunities
- Provide education for practices to develop expertise with metrics and data review for quality improvement, and helps practice to target cost opportunities, high risk Elevance members and gaps in care based on reports provided.
- Supports practice implementation of population health management, care coordination and care management strategies.
- Identifies develops and executes on provider specific 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.
- 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
- Use of the Provider Care Management Solutions (PCMS) tool and other data sources to promote practice transformation, and provides technical support
- Collaborates with 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.
Preferred Skills, Capabilities and Experiences:
- 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.
- Ability to communicate with high level practice contacts
- MS Excel proficiency
- Strong presentation skills
- Experience with multiple sets of data and ability to draw conclusions and identify strategy
- Experience with managing projects
- Medicare and Medicaid experience
- Financial Analysis skills
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.ElevanceHealthinc.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.