Cost of Care Director

About the role

This role requires associates to be in-office 3 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.

Responsibilities

• 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.
• May mentor and/or provide training and assistance to Cost of Care Managers.

Requirements

Requires a BS/BA degree; and minimum of 9 years relevant experience in Health Care; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities And Experiences

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

Benefits

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $109,200 to $195,560. Locations: California; Colorado; Illinois; New York; Washington State and Virginia. In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

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.

Equal Employment Opportunity

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.