Data Analytics Specialist
2 days ago
Evolent partners with health plans and providers to achieve better outcomes for individuals with complex and costly health conditions.
We are seeking a skilled Data Analytics Specialist to join our Performance Suite Analytics team. In this role, you will have the opportunity to generate meaningful impact by translating disparate data points into actionable insights and driving business decisions.
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.
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 significant impact on the organization and patient health.
This role supports both Medical Cost Management activities as well as Business Development efforts.
Key Responsibilities:
- Support the development/underwriting of capitated risk proposals involving cost & use projections, trend selection/development, and estimation of Evolent's ability to reduce costs and improve quality.
- Support the design of financial arrangements that are equitable for both Evolent and our Partners.
- Support the development of new models and approaches aimed at quantifying and articulating our value.
- Perform research and analysis of complex healthcare claims, eligibility, and pharmacy data to make recommendations based on relevant findings.
- Draw actionable conclusions from analyses and effectively communicate to internal/external audiences at various levels of the enterprise.
- Translate analyses into Customer-ready deliverables using available visualization tools.
- Lead and facilitate interaction with customers in a manner that fosters expertise and cooperation.
- Process and validate raw unadjudicated claims data.
- Use programming skills to explore, examine and interpret large volumes of data in various forms to complete deliverables with minimal assistance and oversight.
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).
- 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.
Preferred Qualifications:
- Master's Degree, especially with a quantitative focus (e.g. data science, machine learning, statistics, mathematics, computer science, or engineering).
- Working knowledge of healthcare claims; specifically, differences between institutional vs professional billing and various sites of care/service.
- 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.
Estimated Salary Range: $90,000 - $100,000
Benefits: Comprehensive benefits package including health insurance benefits.
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