Provider Contract Cost of Care Consultant

Location : This position will work a hybrid model (remote and in office one day per week). Ideal candidates will live within 50 miles of one of our Pulse Point locations in Norfolk, VA, Richmond, VA Indianapolis, IN, Atlanta, GA, Mason, OH, or Tampa, FL.

The Provider Contract Cost of Care Consultant provides analytic support to the Finance, Clinical, Cost of Care and Enterprise organizations focusing efforts on explaining medical cost trends, lowering claims costs, and improving the quality of care.

How you will make an impact:

• Provide analytic and consultative support on cost of care issues and medical cost trends.

• Collaborate across multiple business groups to ensure that financial analyses reflect appropriate business considerations and assumptions.

• Work closely with internal business partners providing analyses and helping them understand the risks and impacts of medical policy decisions and other cost of care concepts.

• Analyze and present data related to medical trends.

• Summarize performance using appropriate analytics and tools.

• Develop business performance reports using claims data that tells the drivers behind medical trends.

• Create and publish standard and ad hoc reports.

• Perform healthcare cost and trend analysis to identify strategies to control costs.

• Execute analyses including retrospective data analytics uncovering drivers related to providers, diagnoses, product, and member mix among other many other variables.

• Identify cost of care savings opportunities by analyzing practice patterns.

• Collaborate with other teams by contributing with analyses and acting as a consultant.

• Develop an in-depth understanding of line of business concerns to facilitate novel ways of exploring and explaining trends.

• Provide input and consultative support to Medical Directors, Finance Leaders, and Business Unit Leaders on trend and cost of care issues.

• Present analytic projects during workgroup calls and explain analyses to a diverse audience.

• Participate on project teams involved in regional and enterprise-wide initiatives.

Minimum Requirements:

• Requires BS/BA degree in Mathematics, Statistics, or related field; minimum of 5 years’ experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical analysis and healthcare modeling; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Background in Healthcare Economics strongly preferred.

• Experience with SQL, MS Excel and MS PowerPoint strongly preferred.

• Ability to write SQL queries strongly preferred.

• Experience manipulating large relationship databases strongly preferred.

• Master's degree preferred.