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Tech Stack
Tools & technologiesAWSHadoopPythonSQL
About the role
Key responsibilities & impact- Leading the analytics partnership with Business Development & Product teams in developing the strategic approach for innovative and in-demand value-based care pursuits
- Serving as a strategic partner of our analytics capabilities and processes related to the development/underwriting of capitated risk proposals including cost & use projections, trend selection/development, and estimation of Evolent’s ability to reduce cost and improve quality
- Leading a team in the analysis and interpretation of cost and utilization data (medical and pharmaceutical) to explain potential upside/downside risks of a given arrangement/proposal.
- Partnering with actuarial, finance, and analytics teams to incorporate new products and strategy innovations into existing analytical models and reporting frameworks
- Developing analytical models and synthesizing complex analyses into succinct presentations for internal & external stakeholder buy-in
- Assisting in the development of budgets and forecasts for each new business relationship and packaging key insights for tracking performance
- Collaborating with partner departments to establish best practice processes and efficient workstreams from end to end of the proposal process in terms of prospecting clients, qualifying/outlining a suitable proposal, data intake, analysis, proposal development/communication, client alignment, contracting, and implementation
- Using programming skills to explore, examine and interpret large volumes of data in various forms to complete deliverables with minimal oversight
- Leading and facilitating interaction with customers in a manner that fosters trust, expertise and cooperation
- 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
- Managing, mentoring, and coaching analysts with tasks noted above
- Setting clear goals and objectives and using metrics to measure performance while holding staff accountable
Requirements
What you’ll need- 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 DRGs, Revenue Codes, CPT Codes, RVUs, APMs, 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
- Experience in data mining, advanced/statistical analysis, and data manipulation
- 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 track record of identifying insights from quantitative and qualitative data
- Prior people management experience
- Ability to work independently with limited oversight
- Master's Degree, preferably with a quantitative or healthcare focus (e.g. data science, machine learning, statistics, mathematics, computer science, engineering, public health)
- Previous experience in a medical economics related position within Utilization Management/Clinical Vendor Management functions
- Knowledge of healthcare underwriting methodologies
- 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
- Experience with other languages/platforms such as Python, R, SAS, Hadoop, AWS, ArcGIS
- Experience with BI tools (e.g. Power BI.), Visual Basic, and Microsoft PowerPoint
Benefits
Comp & perks- Comprehensive benefits (including health insurance benefits)
ATS Keywords
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Hard Skills & Tools
healthcare analyticsdata miningstatistical analysisdata manipulationanalytical modelscost projectionstrend selectionbudgetingforecastinghealthcare reimbursement methodologies
Soft Skills
analytical abilitiescommunicationproblem-solvingteam leadershipmentoringcollaborationgoal settingperformance measurementtrust buildingindependent work