LittleRockRecruiter Since 2001
the smart solution for Little Rock jobs

Prov Contract/CofC Consult Sr.

Company: Anthem, Inc
Location: Little Rock
Posted on: March 28, 2020

Job Description:

Prov Contract/CofC Consult Sr. - PS32816Location: United StatesRequisition #: PS32816Post Date: Mar 13, 2020Your Talent. Our Vision. At Anthem, Inc., its a powerful combination, and the foundation upon which were creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care .This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

  • Provides the highest level of analytical support to the Cost of Care and/or Provider Contracting organizations.
  • Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider network satisfaction.
  • Provides expert advice, analytic and consultative support to Medical Directors and management on cost of care issues.
  • Leads large scale initiatives with high dollar cost savings opportunities.
  • Partners with provider contractors to develop contracting strategy and supports all aspects of the contract negotiation process.
  • Works with multiple provider types including the most complex, high profile providers.
  • Supports a full range of contract arrangements and pricing mechanisms including the most complex contract terms.
  • Works on the most complex, large scale enterprise wide initiatives and acts as project lead.
  • Acts as a strategic partner to management.Primary duties may include, but are not limited to:
    • Uses analytic tools to: track both health risks and compliance, as well as supporting the contract negotiation process.Types of analyses include:
      • Performing sophisticated retrospective data analytics;
      • Developing the most complex new models and modifies existing models to create predictive impact decision making tools;
      • Performing healthcare cost analysis to identify strategies to control costs; Projecting cost increases in medical services by using analytic techniques for PMPM trending via multiple variable analysis;
      • Preparing complex pre-negotiation analyses to support development of defensible pricing strategies;
      • Performing modeling to compare various contract scenarios based on member utilization patterns and 'what if'; measuring and evaluating the cost impact of various negotiation;
      • Researching the financial profitability/stability and competitive environment of providers to determine impact of proposed rates;
      • Projects different cost of savings targets based upon various analytics.(Primary duties continued...)
        • Identifies cost of care savings opportunities by analyzing practice patterns in relation to office visits, referral practices, and specialty care procedures and recommends policy changes and claim's system changes to pursue cost savings.
        • Reviews results post-implementation to ensure projected cost savings are realized and recommends modifications as applicable.
        • Recommends standardized practices to optimize cost of care.
        • Educates provider contractors on contracting analytics from a financial impact perspective.
        • May recommend alternative contract language and may go on-site to provider premises during contract negotiations.
        • Researches providers financial profitability/stability and competitive environment to determine impact of proposed rates.
        • Communicates fee strategies to manage provider expectations.
        • Provides on-going analytic and consultative support during complex and the most intense provider negotiations.
        • Educates provider contractors on contracting analytics from a financial impact perspective.
        • May recommend alternative contract language.
        • May go on-site to provider premises during contract negotiations.
        • Acts as a source of direction, training and guidance for less experienced staff. Looks for continuous quality improvements and finds better ways to accomplish end results.
        • Works side by side with their manager.Requires BA/BS degree in Mathematics, Statistics or related field; 7+ years experience in broad-based analytical, managed care payor or provider environment; in depth experience in statistical analysis and modeling; or any combination of education and experience, which would provide an equivalent background. Experience providing leadership in evaluating and analyzing complex initiatives required. Master's degree preferred.Anthem, Inc. is ranked as one of Americas Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

Keywords: Anthem, Inc, Little Rock , Prov Contract/CofC Consult Sr., Other , Little Rock, Arkansas

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Other Jobs


Fresh Food Associate
Description: Careers ul li All Career Areas ul li Back li Stores Clubs ul li Sam---s Club Jobs li Sam---s Club Management Jobs li Walmart Management Jobs li Walmart Store Jobs li Distribution (more...)
Company: Sam's Club
Location: Little Rock
Posted on: 04/10/2020

Store Associate/Stocker - 1722
Description: Performs general store operational duties including cashiering, customer service, truck unloading, stocking, merchandise recovery, and light cleaning or maintenance as assigned.1. Greets and assists customers (more...)
Company: Big Lots
Location: Little Rock
Posted on: 04/10/2020

Benefits Advisor
Description: Job DescriptionBenefits Advisor New Does your current job keep you always on the go Get to know Aflac from the comfort of your home Aflac is proud to now offer virtual interview opportunities at all (more...)
Company: AFLAC
Location: Little Rock
Posted on: 04/10/2020


Benefits Advisor
Description: Job DescriptionBenefits Advisor New Does your current job keep you always on the go Get to know Aflac from the comfort of your home Aflac is proud to now offer virtual interview opportunities at all (more...)
Company: AFLAC
Location: Conway
Posted on: 04/10/2020

.NET Developer
Description: Immediate hiring - .NET Developer in Little Rock, AR TitleJob .NET Developer Location
Company: Intelliblue LLC
Location: Little Rock
Posted on: 04/10/2020

Insurance and Financial Sales - LIFE INSURANCE LICENSED REQ'D (Pine Bluff,AR)
Description: CURRENT LIFE INSURANCE LICENSE REQUIRED TO BE CONSIDERED Are you an individual with a strong desire to succeed in the business world and help families at the same time We have a wide range of mortgage (more...)
Company: The Alliance
Location: Pine Bluff
Posted on: 04/10/2020

Travel Nurse RN - ED - Emergency Department - $1,756 per week
Description: American Mobile Healthcare is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Little Rock, Arkansas: - Specialty: ED - Emergency Department - Discipline: RN - Start Date: (more...)
Company: NurseFly
Location: Little Rock
Posted on: 04/10/2020

Care Coordinator Supervisor
Description: Beacon Health OptionsJob Category: Clinical - GeneralReq : SUPER02481Schedule: Full TimeLocation: AR - Little RockABOUT THE POSITION br br We are currently seeking a group of dynamic Care Coordination (more...)
Company: Beacon Health Options
Location: Little Rock
Posted on: 04/10/2020

Need for Multiple Nephrologists at Rapidly Growing Practice
Description: We would like to introduce our group, Nephrology Associates PA. We are one of the largest Nephrology private practice groups in the state, based in Central Arkansas, providing services to Little Rock, (more...)
Company: Nephrology Associates PA
Location: Pine Bluff
Posted on: 04/10/2020

Emergency Department Nurse
Description: You earned the degree, now get the respect. Nurses are vital to quality patient care, and in the Air--Force, they---re treated that way. Our nurses are respected members of a team of highly trained medical (more...)
Company: U.S. Air Force
Location: Little Rock
Posted on: 04/10/2020

Log In or Create An Account

Get the latest Arkansas jobs by following @recnetAR on Twitter!

Little Rock RSS job feeds