Provider Contract/Cost of Care Consultant
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About The Position
The Provider Contract/Cost of Care Consultant will provide analytical support to the Cost of Care and/or Provider Contracting organizations. This position focuses on lowering claims costs, improving the quality of care, and increasing member and provider network satisfaction. The consultant will provide expert advice, analytic and consultative support to Medical Directors and management on cost of care issues, work on large scale initiatives with high dollar cost savings opportunities, and partner with provider contractors to develop contracting strategy and support all aspects of the contract negotiation process. The role involves working with multiple provider types, supporting a full range of contract arrangements and pricing mechanisms, and using analytic tools to track health risks and compliance. The consultant will perform sophisticated retrospective data analytics, build and modify complex models for predictive decision making, and conduct healthcare cost analysis to identify strategies to control costs. Additionally, the consultant will prepare pre-negotiation analysis, measure cost impacts of negotiations, and recommend policy changes to pursue cost savings.
