Provider Success Consultant - Pay for Quality

Elevance Health•Wallingford, OH

11d•Hybrid

About The Position

The Care Consultant is responsible for fostering long-term partnerships with our providers and driving enhanced patient outcomes. We are seeking a dedicated and experienced Provider Success Consultant to join our team and drive the achievement of value-based care in Medicare and Medicaid lines of business. The ideal candidate will be responsible for 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. If you are passionate about transforming healthcare delivery and possess the expertise to help providers succeed in quality improvement programs, we invite you to apply for this exciting opportunity!

Requirements

Requires a BA/BS and minimum of 3 years health care experience; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

Proven experience in consulting within the healthcare industry.
Experience with Medicaid and Medicare plans strongly preferred.
Strong understanding of quality-focused 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 is preferred.

Responsibilities

Conduct detailed evaluations of provider practices to determine their current capabilities and identify key areas for growth and improvement.
Engage in a continuous process that includes assessment, root cause analysis, strategy development, implementation, and outcomes tracking for each provider.
Assist providers with executing action plans focused on population health management, patient satisfaction, and optimizing quality performance.
Lead collaborative meetings with provider staff and internal stakeholders to ensure alignment and successful deployment of strategic initiatives.
Create and deliver tailored learning opportunities to aid providers in implementing recommended interventions effectively.
Educate providers on using proprietary tools, data, and technology to improve performance in critical metrics, driving effective and efficient care.
Utilize data analytics to continuously monitor and track the key performance metrics for assigned providers, ensuring data-driven decision-making.
Accurately document all action plans, interventions, and provider activities in Salesforce to maintain comprehensive records and reporting capabilities.
Cultivate and maintain strong, long-term relationships with physicians, providers, and healthcare systems to support quality improvements within the health plan contract.
Advise executives on developing segment-specific strategies in areas such as incentive programs, quality management, and other operational areas impacting provider success.
Exercise independent judgment on complex issues, working under minimal supervision to evaluate variable factors and determine optimal courses of action.