Blue Cross and Blue Shield of Louisiana Accountable Care Organization Program Consultant I in Baton Rouge, Louisiana
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POSITION PURPOSE :
The Accountable Care Organization (ACO) Program Consultant will participate in the development and coordination of innovative programs designed to transition from fee-for-service reimbursement to a system based on value. Specifically, the ACO Program Consultant will operationalize the Plan’s total cost of care and shared savings arrangements with Accountable Care Organizations.
The ACO Program Consultant will provide technical and analytical support by independently researching, analyzing, developing, deploying, and monitoring/measuring the performance of provider partners by leveraging utilization, financial, clinical, and benchmark data from multiple internal and external sources. The ACO Program Consultant will serves as the primary contact to help providers understand clinical and economic opportunities to achieve the quality and financial goals of the program, ultimately leading to delivery model redesign.
A bachelor’s degree in statistics, accounting, finance, math, information systems or related field is required. Four years of related healthcare, finance and/or statistical analysis may be used in lieu of degree. An MBA, MHA, CPA, or CFA is preferred
Two years of experience in health care finance or in a related field is required. An MBA, MHA, CPA, CFA or related healthcare, financial or analytically based degree may substitute for one of the two total years of required experience. Healthcare financial analysis and reporting experience is preferred.
Ability to work independently and cooperatively on teams, maintaining positive relations with providers.
Requires strong analytical skills with an ability to navigate multiple software systems and handle large volumes of data.
Excellent analytical, communication, and report preparation skills with highest degree of accuracy are required. Must have the ability to effectively present information to both internal and external stakeholders.
Excellent analytic, problem-solving, decision making and project management skills are required.
Excellent attention to detail, research, and documentation skills are required. High proficiency in Microsoft Office Software (Excel, Word, PowerPoint, and Outlook) is required. Experience using SQL and Access is strongly preferred.
Experience prioritizing, organizing and coordinating multiple work assignments under strict internal and external deadlines often in a high pressure setting with minimal supervision.
Ability to travel 25% and work extended hours.
Responsible for Accountable Care Organization program implementation, focusing on partnering and building relationships with providers to support care delivery transformation through analytics, reporting, and clinical process improvement while cognizant of the current reimbursement and quality improvement programs of the Plan.
Develop and communicate healthcare transformation insights for providers by leveraging utilization, financial, clinical, and benchmark data from multiple internal and external sources.
Provide technical and analytical support, develop methodologies, perform analysis, summarize results, and develop conclusions.
Actively engage providers by analyzing, presenting and translating clinical quality and cost data in meaningful ways to identify actionable items that will improve operations, clinical outcomes, and overall population health
Monitor and research health care and health industry developments on best practices and initiatives in developing new provider payment and network models to support more coordinated, efficient and quality-driven healthcare.
Demonstrate problem-solving, quantitative and analytical skills while validating data for reasonableness/accuracy and adapting to a wide variety of changing analytical situations.
Serves as an effective team player who manages relationships with designated provider partners.
The physical demands described here are representative of those that must be met by an employee to successfully perform the accountabilities (essential functions) of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions.
Job duties are performed in a normal and clean office environment with normal noise levels.
Work is predominately done while standing or sitting.
Physical effort is required to lift, hold, and carry objects up to 15 pounds, occasionally.
Job duties entail using multiple body parts in a coordinated manner.
Manual/Finger dexterity in both hands is needed to operate a keyboard and manipulate small objects.
Sight, hearing, the ability to distinguish colors, and touching are required sensory abilities.
The ability to comprehend, document, calculate, visualize, and analyze are required.
An Equal Opportunity Employer
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To improve the health and lives of Louisianians.
To be the market leader that delivers unsurpassed value to our customers through partnerships across the healthcare system.
Blue Cross and Blue Shield of Louisiana is incorporated as Louisiana Health Service & Indemnity company and is an independent licensee of the Blue Cross and Blue Shield Association. Blue Cross and Blue Shield of Louisiana is licensed to sell products only in the state of Louisiana.
BCBSLA is an Equal Opportunity and Affirmative Action Employer and prohibits discrimination and harassment of any kind. It is the policy of BCBSLA to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, veteran status, or any other characteristic protected by federal, state or local law. In addition, BCBSLA will provide reasonable accommodations for qualified individuals with disabilities. If you are an individual with a disability and need assistance in applying for a position, please contact us at firstname.lastname@example.org.