Location: 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.
The Director II, Provider Economics will be responsible for providing analytical and strategic planning for managing financial modeling, forecasting for payment models and developing reimbursement methodologies for all lines of business to guide the long-term payment strategy for the enterprise.
How you will make an impact:
Evaluates the effectiveness and performance of healthcare networks and related costs and benefits
Collaborate with Carelon Health leaders on the development of alternative payment models that support specialty clinical domains, including VBC penetration, downside risk growth, and performance across financial, quality, and health equity domains.
Uses modeling tools and reporting to identify and quantify contracting and outcomes-based financial impacts of existing and potential new business
Oversees enterprise teams providing analytic and consultative strategy services related to the company's payment model design and program performance
Evaluates new program design and analytic execution strategy of upcoming programs to continuously expand and innovate the multi-year analytic roadmap to ensure value-based care commitments are met
Applies methodologies and modeling of provider payments, financial, and economic measures
Hires, trains, coaches, counsels, and evaluates performance of direct reports
Minimum Requirements:
Requires a BA/BS degree in Business or related field and a minimum of 10 years of experience in broad-based analytical, managed care payor or provider environment as well as minimum of 5 years management experience in the healthcare industry or large multi-operational corporate environment; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
Master's degree strongly preferred
Experience with reimbursement strategy and designing alternative payment models including Capitation, Total Cost Shared Savings/Risk, and Episode Bundle Payments
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. 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.
