Job Description

Business Information Consultant Senior - Provider Economics

The Business Information Consultant Senior is responsible for value-based financial model methodology development, financial model design, and forecasting impact of provider payment models for all lines of business. This position is responsible for serving as an expert in data analysis, reporting and formulating recommendations. This position will value new medical cost initiatives, applying financial modeling expertise and using independent judgment to determine the best methods and approaches to calculate accurate estimates of program savings. Please note: This position is not eligible for current or future visa sponsorship.

Location: Richmond, VA; Woburn, MA; Atlanta, GA; Indianapolis, IN; Cincinnati, OH (preferred). This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

How You Will Make an Impact:

• Establishes, improves, and optimizes the consolidating processes for forecast and month-end results.
• Serve as an analyst and advisory to both internal and external stakeholders, developing value-based payment models and forecasting and measuring value of the Specialty Payment Models.
• Develop financial models for value-based programs.
• Comfortable understanding the operational and technical components of value-based contracts and the systems in which they are run to explain to the market.
• Provide analytical support for strategic initiatives, such as contract negotiations, provider network optimization, and total cost of care management.
• Thoroughly vet and perform due diligence on potential value-based arrangements to assess financial impact, ensure operational feasibility, and identify impact on existing programs.
• Conduct comprehensive analysis of healthcare data, claims, and financial reports to identify trends, patterns, and opportunities for improvement.
• Consolidates and prepares executive summary reports for various business segments in the SBU for top management decision-making.
• Analyzes and designs solutions to address varied and highly complex business needs.
• May collaborate with businesses and technical areas to implement new or enhanced products.
• May require strong knowledge of products as well as our internal business models and data systems.
• May coordinate with external audits as appropriate.
• Acts as the central contact with internal departments and external auditors.

Minimum Requirements:

• Requires a BA/BS degree in Statistics, Economics, or Business Administration and minimum of 8 years of relevant experience; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities. & Experiences:

• Knowledge of IM technologies, organizational structure, and customer information needs strongly preferred.
• Prior leadership or management experience preferred.
• Effective communication skills, including facilitation, consultation, negotiation, and persuasion preferred.
• Deep knowledge of value-based care and/or population health management.
• Progressive experience leading and performing analytical work within the healthcare industry (i.e., health plans, large physician practices, hospitals, ancillary, medical facilities, healthcare vendor, etc.)
• Experienced with SAS, SQL, or similar data manipulation tools, where you have created efficient and transparent queries, pulled large data sets, and performed data manipulations/analysis.
• Skilled at using data to tell financial stories with recommendations on how to create PMPM efficiencies and reduce cost.
• Self-motivated, creative problem solver who can work independently and collaborate through strong communication and interpersonal skills.
• Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
• Significant experience in the healthcare industry in medical economics, provider finance, healthcare analytics, and/or actuarial services.

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.

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.

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