Evry Health

Backend Engineer

• System Architecture & Design: Lead the design and implementation of scalable and maintainable back-end systems, ensuring alignment with business requirements and technical standards.
• Development & Coding: Write efficient and maintainable code using .NET technologies, following best practices for software development, including test-driven development and continuous integration.
• Cloud Infrastructure: Design, deploy, and manage cloud-based services and infrastructure on Microsoft Azure, including databases, storage solutions, and virtual networks.
• Technical Leadership: Provide technical guidance and mentorship to junior engineers, conducting code reviews, and ensuring adherence to established coding standards and practices.
• Performance Optimization: Identify and resolve performance bottlenecks in backend systems, ensuring high availability and reliability of services.
• Collaboration: Work closely with cross-functional teams, including front-end developers and product managers, to deliver software solutions.
• Documentation: Create and maintain technical documentation for systems, processes, and codebases to ensure knowledge sharing and continuity.
• Security & Compliance: Implement and enforce security best practices, ensuring that backend systems are secure and compliant with relevant regulations and standards.
• Problem Solving: Troubleshoot and resolve complex technical issues, providing timely and effective solutions to minimize downtime and ensure smooth operation of systems.

Senior Software Engineer, .NET

Bilingual

• Communicate and provide education to members and providers on insurance plan benefits and digital health solutions.
• Use negotiation and motivational interviewing techniques to increase engagement.
• Provide both proactive outreach and reactive support to members through phone, email, and text.
• Employ active listening & motivational interviewing skills, and can handle difficult calls tactfully, courteously, professionally and document accordingly that can build patient trust and engagement.
• Ability to effectively excel in a virtual work environment through active participation in team huddles, Supervisor 1:1s, Instant Messaging, or check-ins, efficiently answering and documenting member/provider calls.
• Accurately track and document work on a variety of internal software tools and platforms.
• Consult with supervisors, utilization management team, medical directors, as needed to overcome barriers.
• Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure.
• Assist departmental staff with coding, medical records/documentation, pre-certification, reimbursement, and claim denials/appeals.
• Ability to interact with external facility or providers as needed to gather clinical information to support the medical necessity review process and plan of care.

Care Coordination RN – Bilingual, Spanish

Care Coordinator RN – Bilingual, Spanish

QA Engineer

• Perform a wide range of quality responsibilities aimed at maintaining service excellence and driving continuous improvement in the member/provider experience.
• Listen to and score a minimum of 2-3 calls per CSR weekly, focusing on the accuracy of information given in each call and the professionalism displayed. Is the CSR representing the Evry brand in each interaction?
• Audit 2 email support cases per CSR weekly to ensure all facets of the written response are accurate, the response is thorough and utilizes proper grammar/punctuation. All communications should be at the highest level of professionalism and reflect a willingness to assist.
• Become a SME in customer support, utilizing all tools and desk level procedures to guide evaluation of CSR performance. Propose documentation updates or changes to enhance the CSR experience.
• Assist with training new customer support team members as needed.

Customer Support Quality Assurance Analyst

Analyst

• Evry Health is seeking a Healthcare Claims Quality Analyst to support our claims operations team.
• The Quality Analyst will perform in-depth audits of medical claims processing to ensure payment accuracy, healthcare compliance, and adherence to plan benefits and industry regulations.
• Conduct detailed quality audits on complex medical claims, disputes, payment adjustments, and medical claim adjudication decisions.
• Exceed member and provider expectations through excellent quality results.
• Report on trends and training opportunities.
• Develop a rebuttal process to ensure errors are appropriately assigned.
• Create monthly KPI report that summarizes results, top error trends and recommendations for closing any gaps.