Provider Contract/CofC Consultant Senior

Elevance Health • Tampa, FL

1d • Hybrid

About The Position

Provider Contract/COC Consultant Sr role provides the highest level of analytical support to the Cost of Care and/or Provider Contracting organizations. In this role, you will lead efforts to support regulatory reporting requirements for government entities and regulatory bodies. Your primary focus will be on gathering, consolidating, analyzing, and submitting data to ensure compliance with healthcare expenditure regulations and initiatives aimed at increasing healthcare service value. How You Will Make an Impact: Serve as a subject matter expert for regulatory reporting, ensuring that all submissions meet internal and external standards for accuracy and compliance. Collaborate with various teams to gather and interpret requirements related to health insurance data reporting. Retrieve, consolidate, and collate data from multiple data warehouses to produce comprehensive reports. Develop complex reporting applications and strategic data solutions tailored to evolving regulatory needs. Undertakes complex assignments requiring additional specialized technical knowledge. Develops very complex and varied strategic report applications from a Data Warehouse. Establishes and communicates common goal and direction for team. Establishes and maintains advanced knowledge of data warehouse database design, data definitions, system capabilities, and data integrity issues. Acts as a source of direction, training and guidance for less experienced staff. Monitors project schedules and costs for own and other projects. Develops and supports very complex Data Warehouse-related applications for business areas requiring design and implementation of database tables. Conducts training on use of applications developed. This job is focused on spending time thinking about programming and how it would be used to design solutions.

Requirements

• Requires BA/BS degree in Mathematics, Statistics or related field and a minimum of 7 years experience in broad-based analytical, managed care payor or provider environment as well as in depth experience in statistical analysis and modeling; or any combination of education and experience which would provide an equivalent background.
• Expertise in data management tools, business information applications, and programming/query languages (SQL and/or SAS) is required.

Nice To Haves

• Experience in data analysis, reporting, or related areas, preferably within the healthcare sector is helpful.
• Python/R is highly preferred.
• Comprehensive provider-level knowledge, including understanding taxonomy, alternate payment models (e.g., capitation), and value-based care reimbursement systems preferred.
• Awareness of quality measures and initiatives designed to improve healthcare outcomes preferred.
• Ability to communicate effectively with multiple levels within the organization is strongly preferred.

Responsibilities

• Serve as a subject matter expert for regulatory reporting, ensuring that all submissions meet internal and external standards for accuracy and compliance.
• Collaborate with various teams to gather and interpret requirements related to health insurance data reporting.
• Retrieve, consolidate, and collate data from multiple data warehouses to produce comprehensive reports.
• Develop complex reporting applications and strategic data solutions tailored to evolving regulatory needs.
• Undertakes complex assignments requiring additional specialized technical knowledge.
• Develops very complex and varied strategic report applications from a Data Warehouse.
• Establishes and communicates common goal and direction for team.
• Establishes and maintains advanced knowledge of data warehouse database design, data definitions, system capabilities, and data integrity issues.
• Acts as a source of direction, training and guidance for less experienced staff.
• Monitors project schedules and costs for own and other projects.
• Develops and supports very complex Data Warehouse-related applications for business areas requiring design and implementation of database tables.
• Conducts training on use of applications developed.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees