Director, Performance Suite Analytics

Overview

Your Future Evolves Here

Evolent partners with health plans and providers to achieve better outcomes for people with the most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of the 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 the 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. Diversity and inclusion are core to our business.

Join Evolent for the mission. Stay for the culture.

Who You’ll Be Working With

The Director, Performance Suite Analytics, utilizes and develops analytic tools to solve complex business challenges and support decision making that can impact organizational performance and patient health. This role supports capitated risk and value-based strategy development, medical cost management activity, medical economics activity, and a variety of internal operations functions; partnering with Business Development, Product Strategy, Finance/Accounting, Actuarial, EDWBI, Clinical, Performance Solutions and Partner Delivery.

What You’ll Be Doing

• 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 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
• Using programming skills to explore, examine and interpret large volumes of data 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 achieve goals by performing statistical analysis, developing analytic models, and creating data reports/dashboards
• Managing, mentoring, and coaching analysts with tasks noted above
• Setting clear goals and objectives and using metrics to measure performance while holding staff accountable

The Experience You’ll Need (Required)

• 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
• 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
• 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 a track record of identifying insights from quantitative and qualitative data
• Prior people management experience
• Ability to work independently with limited oversight

Finishing Touches (Preferred)

• 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

Technical requirements

We require that all employees have the following technical capability at their home: high-speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. If you need reasonable accommodation to access the information provided on this website, please contact for further assistance.

To comply with HIPAA security standards (45 C.F.R. sec. 164.308 (a) (3)), identity verification may be required as part of the application process. This is collected for compliance and security purposes and only reviewed if an applicant advances to the final interview state. Reasonable accommodations are available upon request.

Salary: The expected base salary/wage range for this position is $130,000-145,000. This position is also eligible for a bonus component based on pre-defined performance factors. Comprehensive benefits are provided as part of the total compensation package.

Don’t see the dream job you are looking for? Drop off your contact information and resume and we will reach out if we find a fitting opportunity.