Lead the development of analytical capabilities and processes related to evaluating performance with our capitated risk partnerships including cost & use projections, financial reconciliations, and providing insight in utilization drivers.
Act as a thought partner to Client & Product teams to outline strategic approach for current risk partnerships, various value-based care models, financial/quality-based metrics, and provide discovery and product design analytical support.
Design and implement standardized, scalable analytical frameworks that enhance efficiency, consistency, and impact across internal teams and external partners.
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 packaging key insights for tracking performance.
Develop models to quantify and articulate value. Communicate actionable conclusions from analyses to executive internal/external audiences.
Collaborating with internal/external business customers to understand their problems and objectives, solve business questions, and help them to achieve goals by performing statistical analysis, developing analytic models, creating data reports/dashboards using a variety of performance metrics.
Partnering with other analytical, product and IT leaders in assessing new and existing analytical tools and continuously improving analytical processes.
Leading and facilitating interactions with existing customers in a manner that fosters trust in Evolent’s expertise and a spirit of collaboration.

Requirements

Bachelor’s degree in a quantitative field (e.g., Data Science, Statistics, Mathematics, Economics, Public Health, or a related discipline)
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.
2+ years in a lead/management role over multiple team members.
Experience directing and developing analytic talent
5+ years of SQL and/or SAS programming experience working with large healthcare datasets
Strong analytical skills with a demonstrated ability to extract meaningful insights from both quantitative and qualitative data
Self-motivated problem-solver with the ability to manage multiple projects simultaneously and adapt to shifting priorities
Effective collaborator who thrives in cross-functional environments, working seamlessly with diverse teams and stakeholders
Deep understanding of prior authorization processes, reporting, and key performance indicators (e.g., approval rates, turnaround times, PMPM, trend drivers), with a working knowledge of healthcare claims and reimbursement methodologies
Experience presenting actionable business insights to client executives and internal leadership is preferred
Familiarity with value-based care models and utilization management frameworks is preferred.

Benefits

health insurance benefits
comprehensive benefits

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills

SQLSASstatistical analysisanalytical frameworksdata reportsanalytic modelsbudgetingforecastingperformance metricshealthcare analytics

Soft skills

analytical skillsproblem-solvingcollaborationleadershipcommunicationadaptabilitytrust-buildingcross-functional teamworkinsight presentationproject management