Provider Success Consultant Sr. West Virginia (Value-Based)

Elevance Health • Charleston, WV

50d • Hybrid

About The Position

Provider Success Consultant Sr. West Virginia (Value-Based) JR173669 Hybrid 1: This role requires associates to be in-office 1 - 2 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. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location will not be considered for employment, unless an accommodation is granted as required by law. The Care Consultant Sr. (Provider Success) is responsible for the provider performance of value-based care payment innovation and collaborative programs across the West Virginia market. The Care Consultant Sr. builds and owns trusting partnerships with senior and executive leadership at provider organizations to drive provider performance in value-based arrangements and enhanced patient outcomes. With a performance-centric mindset, the Care Consultant Sr. is responsible for guiding several priority value-based provider organizations to achieve their targets across quality, utilization of resources, and patient experience. This individual works across all three lines of business (Medicare, Medicaid, and Commercial), marrying quantitative analysis with observational insights to best advise providers on their opportunities for performance improvement. The Care Consultant Sr. is passionate about population health, relationships, and insights to drive transformation across health care delivery and transformation.

Requirements

• Requires a BA/BS and minimum of 5 years health care experience; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

• Travel within West Virginia to visit providers up to 50%.
• Detail orientation, with the ability to move between strategy and operations strongly preferred.
• Independent decision-making ability and judgement on complex issues, working under minimal supervision strongly preferred.
• Strong communicator, both in presentation form as well as in the written word strongly preferred.
• Experience building relationships, from C-suite to front-line staff strongly preferred.
• Deep knowledge of Medicaid, Medicare, and commercial plans as well as value-based care models, principals, and practices strongly preferred.
• Consulting experience preferred.
• Strong analytical skills with the ability to interpret complex data and make strategic conclusions strongly preferred.
• Experience with Salesforce or similar CRM platforms strongly preferred.

Responsibilities

• Trusted Thought Partnership: Serve as key advisory to executive leadership on developing strategies to drive contractual and value-based success. This includes providing expertise and guidance in quality management, financial performance, value-based incentive programs, and practice operations.
• Relationship Management: Cultivate, maintain, and own strong, long-term relationships with executive leadership across population health, quality, finance, and clinical teams. Additionally, serve as an advocate internally to bring in key leaders and internal stakeholders to address provider's needs. Facilitate cross-functional collaboration across payer and provider organizations.
• Consultative Evaluation: Conduct detailed evaluations of provider protocols, processes, and staffing to determine their current capabilities in value-based care and identify key areas for growth and improvement. Engage in a continuous process that iteratively drives toward performance success.
• Strategic Execution: Design and lead strategic plans and initiatives rooted in operational realities to enhance provider performance by highlighting improvement opportunities with innovative value-based care solutions. Marry insights from various data sources to continuously monitor and track key performance metrics for assigned providers, ensuring data-driven decision-making.
• Continuous Improvement: Identify opportunities within the team as well as the broader market to drive greater efficiency and efficacy, fostering a culture of excellent, accountability, and continuous improvement.

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
• Industry: Insurance Carriers and Related Activities
• Number of Employees: 5,001-10,000 employees