Evolent

Analyst

• Analyze healthcare utilization, authorization, and claims data to identify trends, cost drivers, and opportunities for improvement.
• Perform complex data analysis using SQL, PowerBI or Excel to support internal and external stakeholders.
• Develop and maintain reports, dashboards, and performance metrics using tools like SQL, PowerBI, and Excel.
• Automate and optimize recurring reports and ad-hoc analyses.
• Review and QA output, identify trends independently, and communicate key information to teams outside analytics.
• Partner with internal teams (e.g., Clinical Ops, Product, Finance) and external clients to gather requirements and deliver actionable insights.
• Create polished presentations and narratives that highlight key insights and recommendations.
• Identify opportunities to improve data reliability, reporting efficiency, and analytical methodologies.

Senior Analyst, Performance Analytics

Medical Reviewer

• Functions in a clinical review capacity to evaluate all cases that do not pass the authorization approval process at first call
• Reviews charts and analyzes clinical record documentation in order to approve services that meet clinical review criteria
• Conducts ongoing activities which monitor established quality of care standards in the participating provider network and for other clinical staff
• Conducts regular audits, as assigned, to ensure guidelines are applied appropriately
• Converses with medical office staff to obtain additional pertinent clinical history/information, notifies of approvals and denials, giving clinical rationale
• Provides optimum customer service through professional/accurate communication while maintaining NCQA and health plans required timeframes
• Documents all communication with medical office staff and/or treating provider
• Practices and maintains the principles of utilization management by adhering to policies and procedures
• Participates in on-going training programs to ensure quality performance in compliance with applicable standards and regulations

Clinical Reviewer, Speech Therapy

Implementation Specialist

• Support the full implementation lifecycle: development, testing, deployment, and go-live.
• Troubleshoot and resolve technical issues during implementation to ensure smooth transitions.
• Design, build, and maintain data pipelines and ETL workflows using SQL, SSIS, ADF, and Python.
• Interpret and implement data models and mappings for integration tasks.
• Collaborate with cross-functional teams to translate business requirements into technical solutions.
• Monitor and optimize data quality, performance, and reliability.
• Maintain technical documentation and provide post-implementation support.

Implementation Engineer

Administration

• Manage the SaaS life cycle: discover SaaS usage, manage SaaS configuration policies, optimize SaaS entitlements, automate SaaS-related employee onboarding and offboarding processes, measure and publish reports on SaaS usage and costs for IT leadership
• Collaborate with digital workplace engineering & security teams to establish and document SaaS configuration, security controls, compliance requirements and processes to continually identify vulnerabilities in configuration and noncompliant usage of SaaS apps
• Administer and optimize Atlassian platforms (Jira, Confluence, Statuspage, Jira CMDB, JSM Operations, Atlassian Analytics), including migrations, workflow analysis, automation, and integration of third-party apps
• Integrate SaaS and enterprise platforms to enable and streamline IT processes (e.g., ITSM, IAM, ITAM) and business workflows, facilitating tool adoption by understanding stakeholder requirements, managing implementations, and conducting testing and User Acceptance Testing (UAT)
• Produce usage reports and perform system health checks
• Engage with vendors’ support teams to resolve platform issues
• Create and communicate knowledgebase articles to support IT staff and minimize support overhead
• Ensure that the needs of all customers are met accurately and in a timely fashion, as documented in team Service Level Agreements (SLAs)
• Continue to improve technical expertise through research and identification of new processes and technical alternatives to resolve problems and/or implement continuous improvement
• Adhere to and advocate all requirements of IT Privacy and Security Policies and Procedures
• Participate and contribute to project and team meetings. Transfer knowledge, share expertise, and continuously mentor and collaborate with other members of the team.

SaaS Administrator, Enterprise Applications

Full-stack Engineer

• Design, develop, test, and maintain software applications using modern programming languages and frameworks
• Collaborate with product managers, designers, and other engineers to translate requirements into technical specifications
• Write clean, maintainable, and efficient code, following best practices and coding standards
• Participate in code reviews to ensure code quality, functionality, and maintainability
• Troubleshoot, debug, and resolve technical issues and bugs in a timely manner
• Optimize applications for maximum performance, scalability, and reliability
• Contribute to the continuous improvement of development processes, tools, and methodologies
• Stay up-to-date with emerging technologies and industry trends, and apply them to improve our products and solutions

Software Engineer

Platform Engineer

• Engineer and manage observability solutions using OpenTelemetry to monitor and trace application performance
• Contribute to Evolent’s Internal Developer Platform built on Backstage technology via hands on code writing
• Deploy and manage containerization solutions using platforms such as Docker and Kubernetes, with a strong focus on Azure Kubernetes Service (AKS) and Azure Container Apps (ACA)
• Monitor the health and performance of containers and resolve any issues that arise
• Partner with DevOps in advancing Infra as Code and Config as Code discipline
• Participate in Root Cause Analysis (RCA) and actually address root cause to prevent future occurrence of same problem
• Follow security best practice to ensure containerized workloads are fully secure

Platform Engineer, Observability

Vice President

• Serve as a strategic leader responsible for effective management of value-based contracts in the Performance Suite.
• Track and monitor overall financial performance, underlying trends in cost and utilization, and operational and programmatic metrics.
• Leverage data, internal and external client input, and strategic insights to develop client-specific performance plans.
• Collaborate with cross-functional teams to both effectively scale core Evolent programs across clients.
• Oversee a team of strategic and operational leaders with market and project-specific responsibilities.

VP, Client Value

Medical Director

• Provide expert reviews for cardiovascular cases, serving as a specialty-matched expert reviewer for invasive/interventional cardiology cases (e.g., cardiac catheterizations, coronary interventions, endovascular procedures, implantable cardiac devices, etc) that do not initially meet medical necessity guidelines or require further evaluation by a subject matter expert.
• Conduct peer-to-peer discussions with treating providers to ensure appropriate, high-value care aligned with clinical guidelines.
• Collaborate with leadership, management, and clinical staff to address complex cases and support decision-making.
• Act as a key resource for Initial Clinical Reviewers, offering guidance and expertise to ensure the application of best practices.
• Provides clinical rationale for standard and expedited appeals.
• Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request.
• Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines.
• Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner.
• Participates in on-going training per inter-rater reliability process.
• May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support.
• On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director.

Field Medical Director, Interventional Cardiology

• Lead Evolent’s Musculoskeletal (MSK) and Radiology Benefit Management (RBM) programs strategy and execution
• Oversee program design, implementation, and performance management
• Serve as the senior accountable leader to health plan and provider partners
• Identify opportunities to enhance MSK offerings
• Monitor program KPIs, financial impact, and clinical outcomes

VP, MSK, RBM Value

• Serve as the specialty match reviewer in Cardiology cases
• Provides clinical rationale for standard and expedited appeals
• Discuss determinations (peer to peer phone calls) with requesting physicians or ordering providers
• Utilizes medical/clinical review guidelines and parameters
• Ensures documentation of all communications is recorded in a timely and accurate manner
• Participates in on-going training per inter-rater reliability process

Field Medical Director, Cardiology

Financial Planning and Analysis

• Lead and oversee the FP&A and Treasury function
• Communicate complex financial information effectively to executive leadership
• Serve as a trusted advisor with data-driven insights
• Build strong relationships across all departments
• Manage and improve financial forecasting and budgeting processes
• Provide comprehensive financial analysis of operational performance
• Lead, mentor, and develop a high-performing finance team

SVP, Finance and Treasurer

• Provide first-level support, including problem replication, triage, and resolution of issues
• Provide accurate and timely resolution of issues, and escalation when necessary
• Ensure that Service Level Agreements (SLAs) are met
• Maintain and update documentation related to operations and support processes within Confluence
• Contributes to improvement of existing processes and identification of new processes and technical alternatives to resolve problems
• Collaborate with team members and business functions to troubleshoot and resolve support tickets
• Respond to escalations and incidents, providing support toward resolution, and notifying stakeholders of progress during business hours and outside of normal business hours (on-call support)
• Contribute to writing T-SQL code and tools to assist Level 1 support to diagnose and resolve incidents
• Execute SQL scripts to generate reports, troubleshoot data issues, and fulfill database support tasks
• Perform ad-hoc task and analysis for the support team as needed
• Perform quarterly user access audit

Application Support Analyst

• Perform precertification and prior approvals
• Utilization review of outpatient procedures and ancillary services
• Determine medical necessity and appropriateness of services using clinical review criteria
• Document all review determinations and contact providers
• Identify and refer quality issues and potential cases for Care Management

Clinical Reviewer, Nurse – Medical Oncology

Product Manager

• Drive a Product-focused, Partner-First Implementation Strategy
• Work alongside Evolent’s Partner Operations and Strategic Account Teams
• Develop strategies for slotting opportunities well in advance
• Partner with Evolent Engineering to streamline implementations
• Serve as the voice of the customer to communicate Partner-specific configuration
• Develop and lead a high performing team

Managing Director – Product Management

• Support team leaders developing staff schedules, collecting staff performance and customer data
• Reviewing and analyzing relevant data to identify opportunities
• Preparing workforce analysis reports for company leadership
• Monitor clinical resources and workloads in real-time for performance guarantee targets
• Forecast weekly and daily workloads to determine staffing needs
• Work closely with clinical teams on optimization of Workforce Engagement tools
• Ensure accuracy and timeliness of WFM reporting for performance reporting