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Associate Director Performance Suite Analytics

3 months ago

Farmington, New Mexico, United States Evolent Health Full time
*Your Future Evolves Here

  • 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:

  • Our Performance Analytics team offers candidates the opportunity to support the evolution of value-based care across all lines of business by collaborating directly with our health plan partners. We are advocates for creating patient value and demonstrate this by ensuring that our risk based financial arrangements are equitable and sustainable. We are pioneers in supporting the development of new innovative patient solutions through modeling and insights empowered by data.

Collaboration Opportunities:

  • This individual will serve as a key member Performance Suite Analytics team at Evolent primarily focused on leading the supporting analytics for complex financial reconciliations with our risk-based partnerships and will partner closely with executives across finance and account management.

What You Will Be Doing:

  • + Partner with Client & Product teams to outline strategic approach for various Value Based Care pursuits.
  • Lead efforts to analyze capitated risk partnerships including drilling into cost & use trends and estimation of NCH's ability to reduce cost and improve quality.
  • Develop models and approaches to better quantify and articulate our value.
  • Draw actionable conclusions from analyses and effectively communicate to internal/external audiences at various levels of the enterprise.
  • Synthesize complex analyses into succinct presentations for internal/external buy-in
  • Lead and facilitate interaction with customers in a manner that fosters expertise and cooperation.
  • Extract, manage, and analyze claims and operational data to identify trends, insights, and outliers leveraging industry standard metrics such as PMPM, Utilization per 1000, Actuarial Value, Prevalence, and Unit Cost
  • Perform research and analysis of complex healthcare claims, eligibility, and pharmacy data regarding health plan cost & use and make recommendations based on relevant findings.
  • Process and validate raw unadjudicated claims data.
  • Serving as a subject matter expert across multiple technical and/or business domains
  • Managing and/or coaching junior analysts with tasks noted above
  • Using programming skills to explore, examine and interpret large volumes of data in various forms to complete deliverables with minimal assistance and oversight.

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)- Required.
  • years of professional experience in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care, or related healthcare consulting entity- + Advanced or higher proficiency in Microsoft Excel, SQL, or SAS database/statistical programming languages- + Moderate Proficiency in Microsoft PowerPoint- + Experience in data mining, advanced/statistical analysis, and data manipulation- + 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- + Familiarity with healthcare reimbursement methodologies and calculations such as DRGs, Revenue Codes, CPT Codes, RVUs, bundled payments, etc.
  • + Knowledge of health insurance financial business cycle, healthcare quality reporting, and benchmarking, healthcare claims; specifically, differences between institutional vs professional billing and various sites of care/service- + Ability to work independently with limited oversight- + Master's Degree, especially with a quantitative focus (e.g. data science, machine learning, statistics, mathematics, computer science, or engineering)- Preferred.
  • + 5+ years of healthcare economics experience- + Prior people management experience- + 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, Hadoop, AWS, ArcGIS, BI tools (e.g. Tableau, Power BI.), Visual Basic, and Microsoft PowerPoint-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
  • *** for further assistance.
  • The expected base salary/wage range for this position is $90,000 up to $115,000. 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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