Director, Performance Suite Analytics

Your Future Evolves Here

The Director, Performance Suite Analytics, utilizes and develops analytic tools to solve complex business challenges as well as support decision making that can have a considerable impact on organizational performance and patient health. This role supports capitated risk and value-based strategy development, medical cost management activity, medical economics activity, and a variety of internal operations functions; partnering with Business Development, Product Strategy, Finance/Accounting, Actuarial, EDWBI, Clinical, Performance Solutions and Partner Delivery.

What You’ll Be Doing:

• Leading the analytics partnership with Business Development & Product teams in developing the strategic approach for innovative and in-demand value-based care pursuits
• Serving as a strategic partner of our analytics capabilities and processes related to the development/underwriting of capitated risk proposals including cost & use projections, trend selection/development, and estimation of Evolent’s ability to reduce cost and improve quality
• Leading a team in the analysis and interpretation of cost and utilization data (medical and pharmaceutical) to explain potential upside/downside risks of a given arrangement/proposal.
• Partnering with actuarial, finance, and analytics teams to incorporate new products and strategy innovations into existing analytical models and reporting frameworks
• Developing analytical models and synthesizing complex analyses into succinct presentations for internal & external stakeholder buy-in
• Assisting in the development of budgets and forecasts for each new business relationship and packaging key insights for tracking performance
• Collaborating with partner departments to establish best practice processes and efficient workstreams from end to end of the proposal process in terms of prospecting clients, qualifying/outlining a suitable proposal, data intake, analysis, proposal development/communication, client alignment, contracting, and implementation
• Using programming skills to explore, examine and interpret large volumes of data in various forms to complete deliverables with minimal oversight
• Leading and facilitating interaction with customers in a manner that fosters trust, expertise and cooperation
• Collaborating with internal/external business customers to understand their problems and objectives, solve business questions, and help them to achieve goals by performing statistical analysis, developing analytic models, creating data reports/dashboards using a variety of performance metrics
• Managing, mentoring, and coaching analysts with tasks noted above
• Setting clear goals and objectives and using metrics to measure performance while holding staff accountable

The Experience You’ll Need (Required & Preferred):

• Bachelor’s degree, preferably with a quantitative major (e.g. actuarial, statistics, operations research, mathematics, economics) or healthcare focus (health administration, epidemiology, public health, biology)
• At least 5 years of professional experience in claims-based healthcare analytics with a payer, provider, vendor, managed care, or related healthcare consulting entity
• Extensive knowledge of healthcare claims; specifically, differences between institutional vs professional billing and various sites of care/service
• Previous Experience with healthcare reimbursement methodologies and calculations such as DRGs, Revenue Codes, CPT Codes, RVUs, APMs, bundled payments, etc.
• Advanced or higher proficiency in Microsoft Excel
• Advanced or higher proficiency in SQL or SAS database/statistical programming languages
• Moderate Proficiency in Microsoft PowerPoint
• Experience in data mining, advanced/statistical analysis, and data manipulation
• Knowledge of health insurance financial business cycle, healthcare quality reporting, and benchmarking
• Ability to communicate clearly with diverse stakeholders to solve problems; ability to translate between business needs and analytical needs
• Exceptionally strong analytical abilities, with track record of identifying insights from quantitative and qualitative data
• Prior people management experience
• Ability to work independently with limited oversight
• Master's Degree, preferably with a quantitative or healthcare focus (e.g. data science, machine learning, statistics, mathematics, computer science, engineering, public health)
• Previous experience in a medical economics related position within Utilization Management/Clinical Vendor Management functions
• Knowledge of healthcare underwriting methodologies
• Familiarity with value-based care and utilization management
• Understanding of data systems and the critical thinking skills to solve new problems and adapt to changes in data architecture
• Experience with other languages/platforms such as Python, R, SAS, Hadoop, AWS, ArcGIS
• Experience with BI tools (e.g. Power BI.), Visual Basic, and Microsoft PowerPoint

To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration.

Technical Requirements:

We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router.

Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.If you need reasonable accommodation to access the information provided on this website, please contact recruitingteam@evolent.com for further assistance.