[ Position Title:
Cost of Care Dir - ASO Actuarial Client Support

Job Description:

Cost of Care Dir - ASO Actuarial Client Support

Location: Aligned to an Elevance Health office, with a hybrid work schedule. The ideal candidate would be located in Georgia or Virginia, yet this position will consider other locations for the right candidate.

Responsible to assigned Commercial Specialty Business Division (CSBD) market(s) for benefit expense performance and management through the analysis of medical trend and its underlying drivers (but not through reporting relationship). 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 Mgrs.
• Oversee core CoC process including role function, team dynamics, meeting cadences, and ideation workflow for local workgroups/ committees & represent CSBD CoC interests & actively participate in enterprise work group/ committees as applicable.
• Administrate local analysis and ideation sessions with market team, coordinating first pass analytics and prioritization of deep dives.
• Hold monthly ideation sprints & supportive sessions within 30 days & market benefit expense insights including in the context of the monthly close package (to be supported by pre-packaged market trend report).

Minimum Requirements:

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

• Experience working in the managed care/healthcare insurance industry most notably in Cost of Care, Financial, Business, and Leadership strongly preferred.
• MBA, MHA, MA; PMP or Six Sigma Green Belt preferred
• Experience and knowledge of data analytics, project management, project execution, process improvement and change management experience (strategic and execution) strongly preferred.
• Strong organizational, and problem solving skills strongly preferred.
• Excellent written, oral, presentation and interpersonal communication skills with the proven ability to negotiate expectations between multiple parties.
• Proven ability in time management and effective follow-up skills in a fast paced and high demand environment.
• Mastery of Microsoft Office products, most notably Teams, Excel, Word, PowerPoint, and SNOW strongly preferred.

Job Level:
Director Equivalent

Workshift:
1st Shift (United States of America)

Job Family:
PND > Network Contracting
Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

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.

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 - and Elevance Health approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2022, has been ranked for five years running as one of the 2023 World's Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. 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 ability@icareerhelp.com for assistance. ]