Healthcare Economics Consultant/Cost of Care Sr (US) - Military Veterans

Healthcare Economics Consultant/Cost of Care Senior

Locations: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations listed here; Norfolk, VA; Richmond, VA; Tampa, FL; Atlanta, GA; Indianapolis, IN; Cincinnati, OH or Louisville, KY.

The Healthcare Economics Consultant/Cost of Care Senior 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.  Leads large scale initiatives with high dollar cost savings opportunities.

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. 

Minimum Requirements:

Requires BA/BS degree in Mathematics, Statistics or related field and a minimum of 7 years experience in broad-based analytical, managed care payor or provider environment as well as in depth experience in statistical analysis and modeling; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Strong SQL and MS-Excel skills

• Exposure to Tableau or PowerBI

• Experience providing leadership in evaluating and analyzing complex initiatives strongly preferred.

• Master's degree preferred.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

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.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

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 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

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 elevancehealthjobssupport@elevancehealth.com for assistance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.