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Elevance Health · 3 days ago

Provider Contract/Cost of Care Consultant

Atlanta, GA

Contract

Hybrid

Senior Level

5+ years exp

Elevance Health is a health company dedicated to improving lives and communities. The Provider Contract/Cost of Care Consultant provides analytical support to the Cost of Care and Provider Contracting organizations, focusing on lowering claims costs and improving quality of care.

Health CareHealth InsurancePersonal HealthWellness

H1B Sponsor Likely

Responsibilities

Uses analytic tools to track both health risks and compliance, as well as supporting the contract negotiation process

Performs sophisticated retrospective data analytics

Builds new and modifies existing complex models to create predictive impact decision making tools

Performs healthcare cost analysis to identify strategies to control costs

Projects cost increases in medical services by using analytic techniques for PMPM trending via multiple variable analysis

Performs modeling to compare various contract scenarios based on member utilization patterns and 'what if' logic

Researches the financial profitability/stability and competitive environment of providers to determine impact of proposed rates

Projects different cost of savings targets based upon various analytics

Identifies cost of care savings opportunities by analyzing practice patterns in relation to office visits, referral practices, and specialty care procedures

Recommends policy changes and claims system changes to pursue cost savings

Reviews results post-implementation to ensure projected cost savings are realized and recommends modifications as applicable

Recommends standardized practices to optimize cost of care

Educates provider contractors on contracting analytics from a financial impact perspective

Recommends alternative contract language and may go on-site to provider premises during contract negotiations

Participates on project team involved with enterprise-wide initiatives

Acts as a source of direction, training and guidance for less experienced staff

Qualification

Data analyticsStatistical analysisHealthcare modelingSQLCost of care analysisProblem-solvingOrganizational skillsPresentation skills

Required

Requires BS/BA degree in Mathematics, Statistics, or related field

Minimum of 5 years of experience in broad-based analytical, managed care payor or provider environment

Considerable experience in statistical analysis and healthcare modeling

Any combination of education and experience, which would provide an equivalent background

Preferred

Duals experience highly preferred

Proficiency in data manipulation tools such as SQL, SAS, or similar highly preferred

Exceptional analytical, organizational, presentation, and problem-solving skills preferred

Cost of care analysis knowledge preferred

Benefits

Merit increases

Paid holidays

Paid Time Off

Incentive bonus programs

Medical

Dental

Vision

Short and long term disability benefits

401(k) +match

Stock purchase plan

Life insurance

Wellness programs

Financial education resources

Company

Elevance Health

Glassdoor3.6

Elevance Health is an integrated whole-health approach to help people in health journey and address their full range of needs.

Founded in 1944

Indianapolis, Indiana, USA

10001+ employees

https://www.elevancehealth.com

H1B Sponsorship

Elevance Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (488)

2024 (604)

2023 (660)

2022 (222)