Cost of Care Director

Elevance Health; Mason (OH); Hybrid; USD 109,000 - 196,000; Full time

Benefits offered by this job

Comprehensive benefits package

Stock purchase plan

401(k) contribution

Job summary

Elevance Health is seeking a Cost of Care Director to lead enterprise-wide cost of care initiatives, including analytics, contracting, and design of benefits. The role requires strong leadership, financial acumen, and experience with provider networks.

The position is hybrid with in-office requirements and is located within the United States; salary ranges are disclosed in posting and benefits include a comprehensive package.

Qualifications

• Requires a BS/BA degree; and minimum of 9 years relevant experience in Health Care; or combination thereof.

Responsibilities

• Identifies and develops best practices and cost of care improvement processes around network contract negotiation, utilization management, new products and benefit design.
• Oversees identification of potential cost of care savings via analytics with cost of care analytics and actuarial teams for savings quantification.
• Champions cost of care initiatives and collaborates with care management, claims, IT and business partners.
• Manages and presents cost of care projects to senior leadership including State Plan Presidents.
• Serves on local and enterprise committees and participates in cost of care planning meetings.
• Plans, leads and oversees cost of care planning meetings and tracks cost of care projects.
• May mentor or train Cost of Care Managers.

Skills

Financial acumen

Leadership

Data mining

SQL

Provider network contracting

Education

BS/BA degree

Tools

SQL

Job description

Cost of Care Director

Location: This role requires associates to be in-office 3 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.

Join our dynamic Cost of Care Execution team as we add value to the Enterprise! This position will help insure that initiatives are vetted with key stakeholders and deliver on their potential. The Cost of Care Directo r leads and manages multiple cost of care initiatives including the most complex initiatives enterprise wide (e.g. local, within each state, across business segments and at the enterprise level) and drives their execution. Understands, predicts and implements measures to control healthcare costs and to make healthcare more affordable for our customers. Develops, manages, oversees, and executes new and innovative initiatives to manage rising costs and enhance the company's market competitiveness.

How you will make an impact:

• Identifies and develops best practices and cost of care improvement processes around physician, hospital and ancillary network contract negotiation strategies, utilization management efforts, new products, annual benefit design participation, and financial operations.

• Oversees the identification of potential cost of care savings opportunities through complex analytics via partnering with the cost of care analytics team, to developing action plans, benefits and risk assessments and overseeing and partnering with the actuarial team to develop and ensure accurate savings quantification.

• Champions cost of care initiatives, negotiates for human capital resources, and partners with care management, claims, IT, and business partners.

• Manages and presents cost of care projects to senior leadership including State Plan Presidents.

• Serves on local and enterprise committees.

• Plans, leads and oversees cost of care planning meetings and tracks and reports on cost of care projects.

• May mentor and/or provide training and assistance to Cost of Care Managers.

Minimum Qualifications:

• Requires a BS/BA degree; and minimum of 9 years relevant experience in Health Care; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Strongly preferred Financial, Business, and Leadership acumen.

• MBA, MHA, MA; PMP or Six Sigma Green Belt.

• Prior experience with provider network contracting, provider networks, claims, finance, and operations.

• Prior experience with Data Mining, Financial Modeling and SQL.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $109,200 to $195,560.

Locations: California; Illinois: New York; Virginia; Washington State.

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

• The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

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 should submit the Accessibility Accommodation Request Form (https://forms.cloud.microsoft/pages/responsepage.aspx?id=8giMvgesLESaRuvu61vU17EJaA0EP3FIissI8zmZ_NpUNUgyTFRUMkY5NE5JNDFWMkhaUzQxMkJLWS4u&route=shorturl) and a member of the team will be in contact.

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.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration (https://info.flclearinghouse.com/).