Provides 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, and analytic and consultative support to Medical Directors and management on cost-of-care issues
Works on large-scale initiatives with high dollar cost savings opportunities
Partners with provider contractors to develop a contracting strategy and support all aspects of the contract negotiation process
Can work with multiple provider types, e.g. physicians, ancillary, medical groups, or hospitals
Supports a full range of contract arrangements and pricing mechanisms
Works on complex enterprise-wide initiatives and acts as project lead

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
Must have experience with Medicare & Commercial Lines of Business
Experience with relational databases and knowledge of query tools
Ability to manipulate large sets of data
Strong analytical, organizational, and problem-solving skills are strongly preferred
Experience in SQL, SAS, Teradata, and relational databases is highly desired
MS Office Suite of tools desired
Advanced Excel experience preferred
Tableau, Business Objects, or other reporting tools preferred
Good client-facing skills
Exposure to Python and R preferred

Provider Contract, Cost of Care Consultant

Key skills