Director, Performance Suite Analytics

Evolent

21h

About The Position

Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. Our Performance Suite Analytics team offers candidates the opportunity to support the evolution of value-based care across all lines of business by collaborating directly with our health plan partners. We are advocates for creating patient value and demonstrate this by ensuring that our risk-based financial arrangements are equitable and sustainable. We are pioneers in supporting the development of new innovative patient solutions through modeling and insights empowered by data. This individual will serve as a leader in Performance Suite Analytics team at Evolent. This role is primarily focused on leading a team supporting analytics for evaluating financial/quality performance and complex financial reconciliations with our risk-based partnerships. This individual will partner closely with executives across finance, program innovation, and account management.

Requirements

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 Fee for Service, value based care approaches, 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
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
High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router.

Responsibilities

Key leader of the analytics partnership with 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.
Serving as strategic owner of our analytics capabilities and processes related to evaluating performance with our capitated risk partnerships including cost & use projections, financial reconciliations, and providing insight in utilization drivers.
Analyze performance capitated risk partnerships, focusing on cost and use trends, and estimate Evolent’s ability to reduce costs and improve quality.
Assisting in the development of budgets and forecasts for each client and packaging key insights for tracking performance.
Leading and facilitating interactions with existing customers in a manner that fosters trust in Evolent’s expertise and a spirit of collaboration.
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.
Managing, mentoring, and coaching members of the team.
Setting clear goals and objectives using metrics to measure performance while holding staff accountable.
Develop models to quantify and articulate value.
Communicate actionable conclusions from analyses to executive internal/external audiences.
Extract, manage, and analyze claims and operational data using industry-standard metrics.