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Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.
Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.
Join Evolent for the mission. Stay for the culture.
What You’ll Be Doing:
The Performance Suite Analytics team offers candidates the opportunity to generate meaningful impact through translating disparate data points into tangible insights and actions.
Our team values accuracy, collaboration, and innovation, ensuring that all team members receive the support, tools, and skills to positively contribute to Evolent’s broader mission.
Collaboration Opportunities:
The Senior Analyst, 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 the organization and patient health. This role supports both Medical Cost Management activities as well as Business Development efforts. Working in a Medical Economics team that supports Business Development and new product efforts.
What You’ll Be Doing:
- Support the clean data transfer between Evolent and its customers in the Performance Suite where Evolent does not pay claims.
- Support the design of data transfer protocols during client onboarding and implementation, and refinement efforts on an ongoing basis.
- Develop models to evaluate data quality on a regular basis to uncover irregularities in data submitted from clients and work cross-functionally to identify the root cause.
- Apply post-pay audit and payment integrity methods and techniques to ensure claims were paid according to policy
- Coordinate with internal teams to ensure clean and consistent tracking of Evolent’s covered membership and claims
- Support the design of standardized processes, templates, and collateral for key client-facing financial activities
- Create models to assist in financial scope reconciliation efforts.
- Identify potential risks and opportunities related to partner data, enabling leadership to better resource solutions, negotiate contractual terms, or settlements.
- Perform ad hoc client-specific analyses to support strategic decision-making
Qualifications Required and 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)
- 1-3 years of professional experience in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care, or related healthcare consulting entity
- 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 and communicating insights from quantitative and qualitative data
- Advanced or higher proficiency in SQL or SAS database/statistical programming languages and Microsoft Excel
- Experience using data visualization software (s) to package analytical insights (Power BI, Tableau, or similar)
- Experience in data mining, advanced/ statistical analysis, and data manipulation
- Familiarity with healthcare reimbursement methodologies and calculations such as DRGs, Revenue Codes, CPT Codes, RVUs, bundled payments, etc.
- Master’s Degree, especially with a quantitative focus (e.g. data science, machine learning, statistics, mathematics, computer science, or engineering)-Preferred.
- Working knowledge of healthcare claims; specifically, differences between institutional vs professional billing and various sites of care/service-Preferred.
- Familiarity with value-based care and utilization management-Preferred.
- Understanding data systems and critical thinking skills to solve new problems and adapt to changes in data architecture-Preferred.
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. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.
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 recruiting@evolent.com for further assistance.
The expected base salary/wage range for this position is $85,000. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.
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