Director, Risk Analytics

Job not on LinkedIn

🔥 30 minutes ago

🇺🇸 United States – Remote

💵 $130k / year

⏰ Full Time

🔴 Lead

🎲 Risk

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Evolent

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

⚕️ Healthcare Insurance

🏥 Healthcare

☁️ SaaS

Healthcare Insurance • Healthcare • SaaS

Evolent is a healthcare company focused on improving care outcomes through its comprehensive management solutions across multiple medical specialties. They aim to enhance the patient care journey by offering coordinated services in areas like oncology, cardiology, musculoskeletal disorders, and primary care, while ensuring high-quality treatment pathways and cost management. Evolent believes every person deserves quality care, striving to align treatment guidelines and innovative approaches to meet patient needs effectively.

📋 Description

• Lead the Performance Suite Risk Analytics team • Lead analytics supporting evaluation of financial and quality performance and complex financial reconciliations for risk-based partnerships • Partner with finance, program innovation, actuarial, and account management executives • Define strategic approaches for risk partnerships, value-based care models, and financial, quality, and utilization metrics • Provide discovery and product-design analytical support • Own analytics capabilities and processes for evaluating capitated risk partnership performance • Develop cost and utilization projections, financial reconciliations, and insights into utilization drivers • Analyze cost and utilization trends and estimate Evolent’s ability to reduce costs and improve quality • Assist with client budgets and forecasts and package key performance insights • Lead customer interactions and present cost and utilization trends during quarterly performance reviews • Perform statistical analysis, develop analytic models, and create data reports and dashboards • Assess and improve analytical tools and processes with analytical, product, and IT leaders • Manage, mentor, and coach team members • Set goals and objectives, measure performance, and hold staff accountable • Develop models to quantify and articulate value • Communicate actionable conclusions to executive internal and external audiences • Extract, manage, and analyze claims and operational data using industry-standard metrics

🎯 Requirements

• Bachelor’s degree, preferably with a quantitative major or healthcare focus • At least 5 years of professional experience in claims-based healthcare analytics • Extensive knowledge of healthcare claims, including institutional vs. professional billing and sites of care/service • Experience with healthcare reimbursement methodologies, including Fee for Service, value-based care approaches, and bundled payments • 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 work in a very fast-paced environment • Ability to communicate clearly with diverse stakeholders and translate between business and analytical needs • Exceptionally strong analytical abilities and demonstrated ability to identify insights from quantitative and qualitative data • Prior people management experience • Ability to work independently with limited oversight • Government-issued photo ID submission and identity verification during interviews • Comprehensive background check • In-person I-9 verification • May be subject to drug screening prior to employment • High-speed internet over 10 Mbps at home • Ability to plug directly into the home internet router for call center employees

🏖️ Benefits

• Work/life balance • Flexible work arrangements • Autonomy in how work gets done • Health insurance benefits for qualifying employees • Comprehensive benefits package • High-speed home internet requirement/support context (over 10 Mbps)