Director, Performance Suite Analytics Lead

3 weeks ago

Honolulu, Hawaii, United States Evolent Health Full time

Job Summary

Evolent Health partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. Our team seeks to connect the pieces of the fragmented healthcare system and ensure people receive the same level of care and compassion we would want for our loved ones.

About the Role

We are seeking a talented Analytics Director for Value-Based Care to lead our Performance Suite Analytics team. This individual will serve as a leader in developing and implementing analytics strategies to support the evolution of value-based care across all lines of business. The successful candidate will collaborate directly with our health plan partners to create patient value and ensure that our risk-based financial arrangements are equitable and sustainable.

Key Responsibilities

  • Partner with Client & Product teams to outline strategic approaches for current risk partnerships, value-based care models, financial/quality-based metrics, and provide discovery and product design analytical support.
  • Serve as a strategic owner of our analytics capabilities and processes related to evaluating performance with our capitated risk partnerships, including cost & use projections, financial reconciliations, and providing insight into utilization drivers.
  • Analyze performance capitated risk partnerships, focusing on cost and use trends, and estimate Evolent's ability to reduce costs and improve quality.
  • Assist in the development of budgets and forecasts for each client and package key insights for tracking performance.
  • Lead and facilitate interactions with existing customers in a manner that fosters trust in Evolent's expertise and a spirit of collaboration.
  • Collaborate with internal/external business customers to understand their problems and objectives, solve business questions, and help them achieve goals by performing statistical analysis, developing analytic models, creating data reports/dashboards using a variety of performance metrics.
  • Partner with other analytical, product, and IT leaders in assessing new and existing analytical tools and continuously improving analytical processes.
  • Manage, mentor, and coach members of the team.
  • Set clear goals and objectives using metrics to measure performance while holding staff accountable.
  • Develop models to quantify and articulate value.
  • Communicate actionable conclusions from analyses to executive internal/external audiences.
  • Extract, manage, and analyze claims and operational data using industry-standard metrics.

Requirements

  • 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 Fee for Service, value-based care approaches, 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.
  • 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 a track record of identifying insights from quantitative and qualitative data.
  • Ability to work independently with limited oversight.

About Evolent Health

Evolent Health 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.

Compensation

The expected base salary/wage range for this position is $120,000-140,000. 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 Health is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees.

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