Provider Success Consultant Sr. (Ohio Market) at Elevance Health

Independence, Ohio, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

BA/BS degree and minimum of 5 years health care experience (or equivalent combination of education and experience)
Proven experience in consulting within the healthcare industry (preferred)
Experience with Medicaid, Medicare, and commercial plans (strongly preferred)
Strong understanding of value-based care principles and practices (preferred)
Excellent analytical skills with the ability to interpret complex data

Responsibilities

Conduct comprehensive provider assessments to evaluate current capabilities in value-based care and identify areas for growth and improvement
Engage in a continuous consulting support model including assessment, root cause analysis, strategy development, implementation, and outcomes tracking for providers
Assist providers with implementing 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 educational initiatives to help providers implement recommended interventions
Train providers on using proprietary tools, data, and technology to improve performance in critical metrics
Utilize data analytics to monitor and track key performance metrics for assigned providers, enabling data-driven decision-making
Accurately document all action plans, interventions, and provider activities in Salesforce
Cultivate and maintain strong, long-term relationships with physicians, providers, and healthcare systems to support financial and quality improvements
Advise executives on developing segment-specific strategies in financial performance, incentive programs, quality management, and other operational areas
Exercise independent judgment on complex issues with minimal supervision to determine optimal courses of action
Travel to provider locations in Ohio at a minimum of 50% of the time and be in-office 1-2 days per week

Skills

Value-Based Care

Provider Assessments

Root Cause Analysis

Strategy Development

Implementation Support

Data Analysis

Training

Population Health

Medicare

Medicaid

Commercial Healthcare

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters

1944Year Founded

$309.4MTotal Funding

IPOCompany Stage

Enterprise Software, Social Impact, HealthcareIndustries

10,001+Employees

Benefits

Medical, dental, & vision insurance

401(k) + match

Paid holidays

Paid Time Off

Incentive bonus programs

Stock purchase plan

Life insurance

Wellness Programs

Financial education resources

Adoption & Surrogacy Assistance

Dependent-care Flexible Spending Account (DCFSA)

Parental Leave

Parental Transition Week

Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.

Lawsuit against CMS over MA Star Ratings could lead to financial penalties.

CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.

Acquisition of CareBridge enhances home health services within Carelon division.

Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.

Predictive analytics support early disease detection, aligning with Elevance's whole health approach.

Telehealth expansion offers opportunities to reach more patients remotely.

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