Cost of Care Mgr

Location
:
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.
Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

This position is not eligible for employment based sponsorship.

The Cost of Care Mgr is responsible for leading and manages multiple cost of care 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.

How you will make an impact
:

• 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.

Minimum Requirements:

• Requires a BS/BA degree and minimum of 5 years relevant experience in Health Care; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and

Experience:

• Strongly preferred Financial, Business, and Leadership acumen.
• MBA, MHA, MA; PMP or Six Sigma Green Belt strongly preferred.
• Prior experience with provider network contracting, provider networks, claims, finance, and operations strongly preferred.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

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.

Elevance Health operates in a Hybrid Workforce Strategy. Unless…