Value Based Care Consultant Sr. (Provider Success) (Nevada) JR192720

About the role

The Care Consultant Sr. 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.

Responsibilities

• Conduct detailed evaluations of provider practices to determine their current capabilities in value-based care 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.
• Aid providers with executing action plans focused on population health management, patient satisfaction, and optimizing quality and cost 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 financial and quality improvements within the health plan contract.
• Advise executives on developing segment-specific strategies in areas such as financial performance, 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.

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.
• Proven experience in consulting within the healthcare industry.
• Experience with Medicaid, Medicare and Commercial plans preferred.
• Strong understanding of value-based care principles and practices including HEDIS measures.
• Excellent analytical skills with the ability to interpret complex data and make strategic decisions.
• Experience with Salesforce or similar CRM platforms is preferred.

Qualifications

• BA/BS in a related field.
• Minimum of 5 years health care experience.
• Preferred qualifications include proven experience in consulting within the healthcare industry, experience with Medicaid, Medicare and Commercial plans, strong understanding of value-based care principles and practices including HEDIS measures, excellent analytical skills with the ability to interpret complex data and make strategic decisions, and experience with Salesforce or similar CRM platforms.

Benefits

This role offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and a 401(k) match. Additional benefits include medical, dental, vision, short and long term disability benefits, life insurance, wellness programs, and financial education resources.

Pay

The salary range for this specific position is $88,620 to $132,930. Location: Nevada. For candidates working in person or virtually in the below location, the salary* range for this specific position is $88,620 to $132,930.

Schedule

The Care Consultant Sr. 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.

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.