Evolent
Healthcare
Director,PerformanceSuiteAnalytics
“Director, Performance Suite Analytics at Evolent. Skills: Analytics partnership, Value-based care strategy, Capitated risk proposals, Cost & use projections, Trend selection/development, Cost and utilization data analysis, Analytical model development, Data analysis, Statistical analysis. Utilizes and develops analytic tools to solve complex business challenges. Supports decision making that can have a considerable impact on organizational performance and patient health”
What You'll Achieve.
Achieve better outcomes for people with most complex and costly health conditions; Connect the pieces of fragmented health care system; Ensure people get the same level of care and compassion; Support decision making that can have a considerable impact on organizational performance and patient health; Achieve goals by performing statistical analysis, developing analytic models, creating data reports/dashboards using a variety of performance metrics; Tracking performance
Industry & Context.
Solve complex business challenges; Solve business questions; Critical thinking skills to solve new problems and adapt to changes in data architecture
Identity verification steps, Submission of a government issued photo ID, Identity verification during interviews, Final interviews may require onsite attendance, Comprehensive background check, In-person I-9 verification, May be subject to drug screening prior to employment, Use of artificial intelligence tools during interviews is prohibited and monitored, Misrepresentation will result in immediate disqualification from consideration, High speed internet over 10 Mbps, Ability to plug in directly to the home internet router (for call center employees)
What They're Looking For.
Must Have
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 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 ability to translate between business needs and analytical needs, Exceptionally analytical abilities, with track record of identifying insights from quantitative and qualitative data, Prior people management experience, Ability to work independently with limited oversight
Nice to Have
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
What You'll Do.
Utilizes and develops analytic tools to solve complex business challenges
Supports decision making that can have a considerable impact on organizational performance and patient health
Supports capitated risk and value-based strategy development
medical cost management activity
medical economics activity
and a variety of internal operations
Leads the analytics partnership with Business Development & Product teams in developing the strategic approach for innovative and in-demand value-based care pursuits
Serves as a strategic partner of our analytics capabilities and processes related to the development/underwriting of capitated risk proposals
Leads a team in the analysis and interpretation of cost and utilization data (medical and pharmaceutical)
Partners with actuarial
and analytics teams to incorporate new products and strategy innovations into existing analytical models and reporting frameworks
Develops analytical models and synthesizes complex analyses into succinct presentations
Assists in the development of budgets and forecasts for each new business relationship and packaging key insights for tracking performance
Collaborates with partner departments to establish best practice processes and efficient workstreams
Uses programming skills to explore
examine and interpret large volumes of data
Leads and facilitates interaction with customers
Collaborates with internal/external business customers to understand their problems and objectives
solve business questions
and help them to achieve goals
Sets clear goals and objectives and uses metrics to measure performance while holding staff accountable
How You'll Work.
Team & Collaboration
Partnering with Business Development, Product Strategy, Finance/Accounting, Actuarial, EDWBI, Clinical, Performance Solutions and Partner Delivery; Partnering with actuarial, finance, and analytics teams; Collaborating with partner departments; Collaborating with internal/external business customers
Communication Scope
Ability to communicate clearly with diverse stakeholders; Ability to translate between business needs and analytical needs; Synthesizing complex analyses into succinct presentations
Process & Methodology
Setting clear goals and objectives, Using metrics to measure performance, Holding staff accountable
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