Cost of Care Director

Elevance Health•Indianapolis, IN

1d•Hybrid

About The Position

The Cost of Care Director 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. 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. 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. Alternate locations may be considered if candidate resides within a commutable distance from an office.

Requirements

Requires a BS/BA degree
Minimum of 9 years relevant experience in Health Care
Any combination of education and experience, which would provide an equivalent background.

Nice To Haves

Cost of Care knowledge and experience preferred.
Prior experience with managed care, trend & healthcare analytics, provider networks, claims, finance, and operations strongly preferred.
Healthcare payer experience strongly preferred.

Responsibilities

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.