Evolent

Medical Director

• 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

Vice President

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

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.

Analyst

• 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