Cost of Care Director

Elevance Health•Tampa, FL

3d•$109,200 - $195,560•Hybrid

About The Position

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 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.

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.

Nice To Haves

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.

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 Managers.