Evolent

Actuary

• Serve as the lead for medical cost and revenue projections for Performance Suite business
• Partner with Performance Solutions to analyze and size impact of innovative care models
• Oversee Medical Cost Action Planning work to identify, size, and support new programs aimed at reducing cost of care
• Partner with Performance Suite Analytics leaders to understand cost drivers to inform future cost expectations
• Coordinate with internal teams to ensure clean and consistent tracking of Evolent’s covered membership and claims
• Synthesize complex analyses into succinct presentations for communication to key internal and external executive stakeholders
• Partner with team members across the organization to ensure accurate and timely delivery of quarterly forecast updates
• Build tools and capabilities to quantify and narrow range of expected outcomes for financial performance
• Participate in execution of complex deal structures for potential new and existing clients
• Perform ad hoc client-specific analyses to support strategic decision-making

Managing Director, Actuarial Services

Medical Reviewer

• The Nurse Reviewer is responsible for performing precertification and prior approvals.
• Performs utilization review of outpatient procedures and ancillary services.
• Determines medical necessity and appropriateness of services using clinical review criteria.
• Collaborates with physicians and other providers to facilitate provision of services throughout the health care continuum.

Clinical Reviewer, Nurse

Analyst

• Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, and population health opportunities using SAS, SQL, Excel, and Power BI (or similar BI tools)
• Work with stakeholders to understand business needs, proactively clarify requirements, and develop actionable recommendations
• Enhance and standardize analytical solutions for internal teams and external partners
• Support ad hoc and regulatory reporting needs efficiently, ensuring compliance with applicable guidelines
• Present findings in client-facing decks, data-driven narratives, and visualizations that convey insights effectively
• Partner with internal stateside and global teams to deliver high-quality analyses

Senior Analyst, Client Analytics

• Integrate and analyze claims and enrollment data from multiple sources using SAS and SQL programs.
• Import and load data from disparate sources to facilitate reporting for multiple health plans.
• Build new client relationships to understand analytical and reporting needs.
• Create actionable, innovative analytics solutions that drive decision-making for clients by performing medical economics analyses to determine cost and utilization drivers.
• Showcase standard stack of reporting capabilities while assessing the fit to client’s needs and desires.
• Relay enhancements and improvements to development team.
• Bring deliverables and capabilities as set forth in SOW and contracts to life.
• Monitor incoming data files to ensure data is up to date, complete, and accurate.
• Disseminate feedback and coordinate participation within Analytics team (including actuarial, risk analytics, data science, and development).
• Track efficiencies, support processes and workflow, and identify process improvement opportunities.
• Sign-off on design and flow of client data.
• Facilitate analyses of analytical deliverables.
• Deliver analytical deliverables prior to go-live.
• Working on an operational analytics team supporting Evolent’s clinical services (i.e., specialty care, utilization management, care management, appeals & grievances)

Client Analytics Analyst

• Partner with Business Development, Implementations, and Analytics to develop a client onboarding roadmap
• Accountable for the project management of all analytical needs throughout the client implementation process
• Develop and implement a client readiness strategy
• Key Liaison between the Client and internal Analytics/IT for data acquisition
• Analyze impact of deviations from original underwriting and make recommendations
• Onboard and Train Client Analytics Staff on newly implemented clients

Senior Analyst, Performance Suite Analytics

Financial Planning and Analysis

• Serve as the primary finance partner to the Services leadership team, owning end-to-end financial performance and decision support.
• Lead and develop a high-performing FP&A team, fostering a culture of accountability, collaboration, and continuous improvement.
• Communicate complex concepts clearly and persuasively through both written materials and verbal presentations, tailoring messaging for executive audiences and cross-functional stakeholders at all levels.
• Act as a strategic advisor, building trusted relationships with business leaders and providing financial insights to support decision-making.
• Drive cross-functional initiatives in partnership with Operations Finance, Client Finance, Talent, and other teams to align financial planning with business execution.
• Synthesize complex financial data into clear, actionable insights for executive stakeholders.
• Lead budgeting, forecasting, long-term planning, and performance management processes for the Services business.
• Coordinate staffing strategy, growth plans, and client go-lives in collaboration with Operations Finance.
• Champion innovation in financial processes and tools, including automation and technology enhancements for forecasting and reporting.
• Manage multiple priorities and projects simultaneously, ensuring timely and accurate execution of deliverables.

Senior Director, Finance – FP&A & Strategy

Operations

• Ensure our AI systems deliver consistent, reliable, and compliant results in healthcare settings
• Develop and maintain standardized evaluation frameworks to consistently measure LLM performance across relevant healthcare metrics
• Build monitoring systems using Logfire to track AI model performance, detect drift, and alert the team to anomalies
• Create testing infrastructure for prompt versions, model selection, and quality assurance processes
• Design and implement audit sampling processes for continuous quality monitoring and clinical review workflows
• Oversee regulatory compliance processes, including documentation for bias assessments, model cards, and audit trails required in healthcare
• Optimize LLM operations through intelligent model selection, prompt engineering, and cost management strategies
• Support the transition from successful POCs to production-ready services with appropriate testing and validation
• Partner with DevOps on infrastructure requirements while focusing on AI-specific monitoring and optimization
• Create and maintain documentation, runbooks, and operational procedures for all deployed AI systems
• Collaborate with Clinical Support Liaison to incorporate clinical feedback into system improvements
• Prepare regular reports on AI system quality, performance metrics, and compliance status

ML/LLM Operations Engineer

Vice President

• Lead cardiology - and vascular-related utilization management, quality improvement, and clinical operations
• Ensure consistent, high-quality adjudication of cardiology decisions
• Serve as a strategic liaison between clinical teams and clients
• Partner closely with Evolent’s Growth and Strategic Accounts teams

Vice President, Cardiology

Executive Assistant

• Support General Counsel and Deputy General Counsel with administrative duties
• Proactively manage a complex and dynamic calendar to ensure alignment with executive priorities
• Review, prioritize and respond to emails, phone calls, meeting notes, and follow up action items
• Organize and maintain records and databases related to the executive's work, including preparing and editing papers, reports, presentations and other materials
• Handle confidential and sensitive information with discretion and professionalism
• Research and analyze data and information to support executive decision making
• Liaise with internal and external stakeholders, clients, partners and vendors
• Collaborate with other executive assistants on scheduling and project tasks
• Perform administrative tasks such as travel arrangements, expense reporting, and time tracking
• Take notes at meetings and assist with team-specific project work, briefings, and presentations as needed

Executive Assistant II

• Functions in a clinical review capacity to evaluate all cases which do not pass the authorization approval process at first call
• Routinely interact with leadership and management staff, other CR’s, providers, office staff and Field Medical Directors (FMDs)
• Reviews charts and analyzes clinical record documentation 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
• 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 and 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 and may be audited to ensure guidelines are applied appropriately

Clinical Reviewer, Nurse – Cardiology

Data Engineer

• Lead the design, development, and deployment of complex data solutions, ensuring scalability and maintainability
• Architect and implement high-performance data pipelines and data warehousing solutions that support critical business functions
• Collaborate closely with cross-functional teams, including product managers, UX designers, and other engineers, to translate business needs into technical data solutions
• Conduct thorough code reviews, providing constructive feedback and ensuring adherence to best coding practices
• Mentor and coach junior data engineers, fostering a culture of continuous learning and technical excellence
• Identify and implement improvements to the data engineering lifecycle, including automation, testing, and CI/CD pipelines
• Troubleshoot and resolve production data issues, working to ensure high availability and reliability of data services
• Evaluate and integrate new tools, frameworks, and technologies to improve data engineering processes and team productivity
• Drive the technical vision for data projects, contributing to architectural discussions and long-term planning

Senior Data Engineer

Full-stack Engineer

• Architecting, developing and maintaining technical processes around the Cache / MUMPS assets
• Be a part of an application development IT shop through the requirement, design, development, SDLC cycles with a focus on Cache and relational database technologies
• Lead aspects of services-based solutions and internal applications to ensure consistency, quality, architectural integrity, scalability, and availability
• Hands-on engineer supporting client implementation during design, development and maintenance of Evolent’s core platforms, including web applications, services and data management routines
• Investigate and integrate advances in software engineering technology and practices into the overall development process
• Help to resolve questions of program intent, software requirements, and inclusion of internal checks and controls
• Develop software solutions using industry best practices around security and performance in a web and SOA architecture environment
• Collaborate with team and business owners in the development and/or execution of software considering organizational objectives
• Participate in the full systems life cycle with solution design, development, implementation, and product support using scrum and other agile methodologies
• Maintain source-code repository, participate in deployment of code into production, and contribute to continuous integration improvements
• Communicate project status and forecasting to internal clients and develop metrics for gauging success using issue tracking software like Jira
• Identify and implement new technologies and provide thought leadership in strategy and technology

Software Engineer, Cache

Medical Director

• Serve as the Physician Clinical Reviewer for Interventional Pain Management, reviewing cases that do not initially meet applicable medical necessity guidelines
• Review imaging requests when providers, clients, or state laws require specialty reviews by the subject matter expert
• Discuss determinations (peer to peer phone calls) with requesting physicians or ordering providers within the regulatory timeframe
• Utilize medical/clinical review guidelines and parameters to assure consistency and compliance with SBU policies/procedures, URAC, and NCQA guidelines
• Provide clinical rationale for standard and expedited appeals
• Ensure documentation of all communications with medical office staff and/or MD providers is recorded timely and accurately
• Participate in ongoing training per inter-rater reliability process
• May function as Medical Director for selecting health plans or regions on request, working with the Senior Medical Director
• May assist the Senior Medical Director in research activities/questions
• Routinely interact with leadership and management staff, other Physicians, and staff; aid and act as a resource to Initial Clinical Reviewers

Field Medical Director, Pain Management

Account Manager

• Account Manager working directly with one of Evolent’s largest clients with unique insight to individual markets
• Responsible for operational excellence, implementing relationship best practices, understanding and delivering upon growth opportunities and driving value-based communication
• Support an assigned book of business strategically to achieve relationship, growth, retention, and customer goals
• Pull and analyze data from internal systems to support client needs, identify trends, monitor performance, and drive operational insights
• Create and deliver regular and ad hoc reporting to both internal teams and client partners, including dashboards and performance summaries
• Support preparation for client JOC meetings by leveraging data and insights to develop agendas, presentation materials, and action plans
• Proactively manage client operational end to end resolution in a timely manner and be client-facing for associated role responsibilities
• Develop and manage monthly, quarterly, and annual client reporting, including quality review and client Q & A reporting
• Understand and monitor performance to SLA expectations and track/monitor client requirements/projects to agreed specifications
• Run efficient/effective meetings and work sessions with the client and relevant Subject Matter Experts
• Maintain a sound knowledge of the client’s business and a comprehensive knowledge of Evolent’s specialty products and services
• Review and validate accuracy of client deliverables prior to external distribution

Account Manager, Strategic Accounts

• Key member of the utilization management team providing non-clinical review support
• Serve as the Physician match reviewer for Hip/Knee/Shoulder Surgery cases and other imaging requests requiring specialty review
• Discuss determinations (peer-to-peer calls) with requesting physicians/providers within regulatory timeframes and provide clinical rationale for appeals
• Utilize medical/clinical review guidelines and parameters to ensure consistency and compliance with SBU policies, URAC and NCQA guidelines
• Aid and act as a resource to Initial Clinical Reviewers
• Ensure documentation of all communications with medical office staff and/or MD providers is timely and accurate
• May assist the Senior Medical Director in research activities related to Utilization Management, interpretation, guidelines and/or system support
• Participate in on-going training per inter-rater reliability process
• Opportunity to make a meaningful difference in patients’ lives in a non-clinical environment

Field Medical Director, MSK Surgery

• Key member of the utilization management team handling vascular surgery cases
• Serve as the specialty match reviewer for vascular cases and other imaging requests when specialty review is required
• Discuss determinations (peer-to-peer calls) with requesting physicians within regulatory timeframes
• Provide clinical rationale for standard and expedited appeals
• Utilize medical/clinical review guidelines and parameters to ensure appropriate utilization and compliance with SBU policies, URAC, and NCQA
• Act as a resource to Initial Clinical Reviewers and participate in inter-rater reliability training
• Ensure documentation of all communications with medical office staff and/or MD providers in a timely and accurate manner
• Assist Senior Medical Director with research related to Utilization Management and may function as Medical Director for selected plans/regions on request
• Non-clinical role offering improved work-life balance and remote work from home

Field Medical Director – Vascular Surgery

The Vice President, Strategic Accounts will serve as a senior leader responsible for managing and growing key client relationships across Evolent’s portfolio.
This role is central to driving client satisfaction, retention, and expansion, while ensuring alignment with Evolent’s strategic goals and operational excellence.
Collaborates with internal teams (Provider Solutions, Strategic Accounts, Analytics, Client Finance, Implementation, Clinical Operations, Medical, Quality, Call Center Teams) to identify new opportunities, deploy and optimize Evolent programs, and achieve client and organizational objectives.
Account/ Relations Management – provide corporate, executive and overall account management for designated client partners, including the CEO, CFO, CMO, pharmacy leadership, clinical operations/UM, medical economics/actuarial services/analytics, and vendor management.
Performance Management – maintain overall accountability for partner value and ROI performance of designated client partners.
Partner/Provider Satisfaction – maintain overall accountability for the satisfaction of designated partners.
Initiative Deployment – accountable for client-specific deployment of clinical, product/platform, and operational improvement initiatives to improve performance, satisfaction, and clinical quality/outcomes.
Teamwork/Collaboration – serves as a liaison between the customer and key Evolent stakeholders; monitors issue resolution and ensures appropriate, timely follow up by Evolent team members.
Staff Management – manages assigned staff as requested to optimize the performance and satisfaction of designated client partners, their provider networks, and where applicable, ASO employer accounts.

Vice President, Strategic Accounts

• Serve as the Physician match reviewer in Medical Oncology and imaging cases that do not initially meet applicable medical necessity guidelines
• Discuss determinations (peer-to-peer calls) with requesting physicians or ordering providers within regulatory timeframes and provide clinical rationale for appeals
• Utilize medical/clinical review guidelines to assure consistency with SBU policies/procedures, URAC and NCQA guidelines
• Aid and act as a resource to Initial Clinical Reviewers
• Ensure documentation of all communications with medical office staff and/or MD providers in a timely and accurate manner
• May assist the Senior Medical Director in research related to Utilization Management processes, interpretation, guidelines, and system support
• Participate in ongoing training per inter-rater reliability process

Field Medical Director, Oncology

Project Manager

• With minimal supervision, guide day-to-day activities for at least one strategic initiative or partner project
• Develop, monitor, and manage project work plan, deliverables, and activities
• Independently facilitate project meetings and effectively communicate project status
• Identify and manage dependencies and project impacts across business areas
• Proactively identify, monitor, document, and communicate project risks and issues
• Hold project team accountable to critical path timelines to ensure deadlines are met
• Build and maintain relationships with project team members, business owners, building an internal network of trusted partners.
• Craft communications by considering both the audience and situation
• Collaborate with Program Managers, Project Managers, Business and Testing Analysts on strategic initiatives and partner implementations

• Integration testing in the healthcare ecosystem requires complete end to end testing in the specialty domain.
• Test data is analyzed to inform decision makers.
• Data is reported to provide teams precise test data or stakeholders answers to questions.
• Technical testing is exercised to ensure source to target integrity.
• The IQ Analyst (IQA) performs analysis, reporting, and technical testing across multiple domains.
• Active domains under test require technical experts to find the most valuable defects.
• The IQA reports to a associate director or a manager.
• One or many IQAs may be engaged in any testing effort
• The day-to-day point of contact and escalation representing IQ technically for assigned scope
• Responsible to escalate risks and issues in coordination with the lead / manager for status reporting
• Responsible to enforce department standards as directed by the lead / manager
• Consult for test plan creation, maintenance, approval, & socialization (level set) by the lead / manager
• Responsible to build the test suite supporting assigned scope in a timely manner including: create & maintain test cases required to analyze source & target integrity across various databases supporting transaction processing based on the end-to-end data flow
• create & maintain queries required to analyze system processing in detail
• provide summary information to stakeholders & management answering business questions
• create & maintain queries supporting precise test data for user acceptance test cases
• perform administrative tasks for status reporting or other data related needs
• Consult for sequencing of end-to-end testing dependencies with the lead / manager as identified for use in the master schedule
• Responsible to execute test cases and record results for assigned technical scope during test execution
• Responsible to triage discrepancies, set defect priority & urgency, and enter defects found by testing teams during test execution
• Consult with the manage and report risk, issues, and decisions with the lead / manager
• Responsible to attend and if required, lead test team meetings for technical testing activities
• Responsible to escalate environment needs and outages to the lead / manager during execution
• Responsible to maintain assigned test assets on a frequent basis for assigned technical scope
• Assigned other duties as required

Analyst, Integration Quality

DevOps Engineer

• Designing, implementing, and managing containerization solutions using platforms such as Docker and Kubernetes, with a strong focus on Azure Kubernetes Service (AKS) and Azure Container Apps (ACA ).\n• Develop and maintain continuous integration and delivery pipelines ( CI/CD ) using GitHub.\n• Collaborate with the software development team to containerize existing applications and deploy them on Azure.\n• Automate deployment, scaling, and management of containerized workloads on Azure.\n• Follow security best practice to ensure containerized workloads are fully secure.\n• Partner with SRE in advancing Infra as Code and Config as Code discipline.\n• Keep up to date with the latest industry trends and technologies in containerization.\n• Thoroughly document processes and configurations related to containerization efforts.\n• Mentor other team members in microservice architecture and containers orchestration.