Analyst, Performance Suite Analytics

Summary

Evolent partners with health plans and providers to improve outcomes for people with complex and costly health conditions. The Analyst, Performance Suite Analytics supports medical cost management and business development by analyzing healthcare data, underwriting capitated risk proposals, developing financial models, and translating findings into actionable, customer-ready insights.

Responsibilities

• Support the underwriting of capitated risk proposals involving cost & use projections, trend selection/development, and estimation of Evolent s ability to reduce cost and improve quality
• Support the design of financial arrangements that are equitable for both Evolent and our Partners
• Support the development of models and approaches aimed at quantifying and articulating our value
• Perform research and analysis of complex healthcare claims, eligibility, and pharmacy data to make recommendations based on relevant findings
• Draw actionable conclusions from analyses and effectively communicate to internal/external audiences at various levels of the enterprise
• Translate analyses into Customer-ready deliverables using available visualization tools
• Provide support and facilitate interaction with customers in a manner that fosters expertise and cooperation
• Process and validate raw unadjudicated claims data
• Use programming skills to explore, examine and interpret large volumes of data in various forms to complete deliverables with minimal assistance and oversight

Skills

• Bachelors degree, preferably with a quantitative major (e.g. actuarial, statistics, operations research, mathematics, economics) or healthcare focus (health administration, epidemiology, public health, biology)
• 1-2 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
• Exceptional analytical and communication skills with the ability to identify and translate insights from quantitative and qualitative data
• Proficiency in SQL or SAS database/statistical programming languages or related programming language
• Advanced proficiency in Microsoft Excel
• 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
• Experience using data visualization software (s) to package analytical insights (Power BI, Tableau, or similar)
• Masters Degree, especially with a quantitative focus (e.g. data science, machine learning, statistics, mathematics, computer science, or engineering)
• Working knowledge of healthcare claims; specifically, differences between institutional vs professional billing and various sites of care/service
• 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
• 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
• Familiarity with healthcare reimbursement methodologies and calculations such as DRGs, Revenue Codes, CPT Codes, RVUs, bundled payments, etc. Preferred
• Experience using data visualization software (s) to package analytical insights (Power BI, Tableau, or similar)- Preferred
• Masters Degree, especially with a quantitative focus (e.g. data science, machine learning, statistics, mathematics, computer science, or engineering)- Preferred
• 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 of data systems and the critical thinking skills to solve new problems and adapt to changes in data architecture- Preferred

Qualifications

Must Haves

• Bachelors degree, preferably with a quantitative major (e.g. actuarial, statistics, operations research, mathematics, economics) or healthcare focus (health administration, epidemiology, public health, biology)
• 1-2 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
• Exceptional analytical and communication skills with the ability to identify and translate insights from quantitative and qualitative data
• Proficiency in SQL or SAS database/statistical programming languages or related programming language
• Advanced proficiency in Microsoft Excel
• 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
• Experience using data visualization software (s) to package analytical insights (Power BI, Tableau, or similar)
• Masters Degree, especially with a quantitative focus (e.g. data science, machine learning, statistics, mathematics, computer science, or engineering)
• Working knowledge of healthcare claims; specifically, differences between institutional vs professional billing and various sites of care/service
• 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
• 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

Nice to Haves

• Familiarity with healthcare reimbursement methodologies and calculations such as DRGs, Revenue Codes, CPT Codes, RVUs, bundled payments, etc. Preferred
• Experience using data visualization software (s) to package analytical insights (Power BI, Tableau, or similar)- Preferred
• Masters Degree, especially with a quantitative focus (e.g. data science, machine learning, statistics, mathematics, computer science, or engineering)- Preferred
• 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 of data systems and the critical thinking skills to solve new problems and adapt to changes in data architecture- Preferred

Benefits

• Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done.
• Comprehensive benefits (including health insurance benefits) to qualifying employees.