Senior Analyst, Performance Suite Analytics

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🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $88k / year

⏰ Full Time

🟠 Senior

🧐 Analyst

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Evolent

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

⚕️ Healthcare Insurance

☁️ 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

• Utilize and develop analytic tools to solve complex business challenges and support decision making • Support clean data transfer between Evolent and its customers in the Performance Suite where Evolent does not pay claims • Support design of data transfer protocols during client onboarding and implementation, and refinement efforts on an ongoing basis • Develop models to evaluate data quality on a regular basis to uncover irregularities in data submitted from clients • Apply post-pay audit and payment integrity methods and techniques to ensure claims were paid according to policy • Coordinate with internal teams to ensure clean and consistent tracking of Evolent’s covered membership and claims • Support design of standardized processes, templates, and collateral for key client-facing financial activities • Create models to assist in financial scope reconciliation efforts • Identify potential risks and opportunities related to partner data, enabling leadership to better resource solutions, negotiate contractual terms, or settlements • Perform ad hoc client-specific analyses to support strategic decision-making

🎯 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) • 1-3 years of professional experience in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care, or related healthcare consulting entity • 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 and communicating insights from quantitative and qualitative data • Advanced or higher proficiency in SQL or SAS database/statistical programming languages and Microsoft Excel • Experience using data visualization software (s) to package analytical insights (Power BI, Tableau, or similar) • Experience in data mining, advanced/ statistical analysis, and data manipulation • Familiarity with healthcare reimbursement methodologies and calculations such as DRGs, Revenue Codes, CPT Codes, RVUs, bundled payments, etc. • Working knowledge of healthcare claims; specifically, differences between institutional vs professional billing and various sites of care/service- Preferred. • Familiarity with value-based care and utilization management- Preferred. • Understanding data systems and critical thinking skills to solve new problems and adapt to changes in data architecture- Preferred.

🏖️ Benefits

• health insurance benefits • work/life balance • flexibility to suit their work to their lives • autonomy to get things done