Care Consultant Sr (IN, KY, OH)

Elevance Health•Cincinnati, OH

3d•Hybrid

About The Position

The Care Consultant Sr (IN, KY, OH) is responsible for fostering long-term partnerships with our providers and driving enhanced patient outcomes, driving the achievement of value-based care in the Medicare, Medicaid, and Commercial lines of business. This individual will be consulting with providers, conducting assessments, and deploying interventions to enhance capabilities and performance. This role involves a variety of tasks such as strategy development, implementation support, training, and data analysis to ensure the success of our provider partners.

Requirements

Requires a BA/BS and minimum of 5 years health care experience; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

Physician environment experience in practice transformation/quality improvement, ambulatory care setting quality and efficiency metrics, population health and care management structures, data analytics and electronic health records.
Clinical background and/or MBA.
Proven experience in consulting within the healthcare industry.
Experience with Medicaid, Medicare, and commercial plans strongly preferred.
Strong understanding of value-based care principles and practices.
Excellent analytical skills with the ability to interpret complex data and make strategic decisions.
Experience with Salesforce or similar CRM platforms.
Effective communicator and facilitator.

Responsibilities

Conduct detailed evaluations of provider practices to determine their current capabilities in value-based care and identify key areas for growth and improvement.
Obtain and analyze practice specific cost and quality data and reports for cost of care and quality opportunities.
Help practice target high risk members and gaps in care based on reports provided, supports practice implementation of population health management, care coordination and care management strategies, identify action plans for providers to implement to improve cost, quality and the patient experience and participate in design, development, and implementation of community learning forums.
Serve as the point of contact for providers and primary care practices for program on boarding, facilitation of routine meetings with the provider office, serve as the subject matter expert and liaison with Care Management to facilitate clinical processes between the company and the provider office.
Create and deliver tailored learning opportunities to aid providers in implementing recommended interventions effectively.
Advise executives on developing segment-specific strategies in areas such as financial performance, incentive programs, quality management, and other operational areas impacting provider success.