Senior Analyst, Performance Suite Analytics

This is a fully remote position, open to applicants in United States.

📋 Description

• Create and utilize analytical tools to address intricate business issues and enhance decision-making for both the organization and patient health.

• Assist in the development and underwriting of capitated risk proposals, which encompass cost and utilization forecasts, trend identification and development, and assessing Evolent’s capacity to lower costs while enhancing quality.

• Aid in structuring fair financial agreements for Evolent and its partners.

• Formulate models and strategies to quantify and express Evolent’s value.

• Conduct research and analysis on complex healthcare claims, eligibility, and pharmacy data.

• Derive actionable insights and convey findings to both internal and external stakeholders.

• Convert analyses into customer-ready materials using visualization tools.

• Lead and facilitate interactions with customers.

• Process and verify raw unadjudicated claims data.

• Investigate, analyze, and interpret large datasets using programming skills with minimal supervision.

• Support Medical Cost Management, Business Development, and initiatives for new product offerings.

⛳️ Requirements

• Bachelor’s degree, ideally in a quantitative field or with a healthcare emphasis.

• 1-3 years of relevant professional experience in claims-based healthcare analytics.

• Capability to communicate effectively with a diverse range of stakeholders and bridge the gap between business and analytical requirements.

• Exceptional analytical skills with a proven ability to identify and articulate insights from both quantitative and qualitative data.

• Advanced or higher proficiency in SQL or SAS and Microsoft Excel.

• Experience with data visualization tools such as Power BI, Tableau, or similar software.

• Proficiency in data mining, advanced/statistical analysis, and data manipulation.

• Knowledge of healthcare reimbursement methodologies and calculations, including DRGs, Revenue Codes, CPT Codes, RVUs, and bundled payments.

• A Master’s degree with a quantitative focus is preferred.

• Familiarity with healthcare claims, including distinctions between institutional versus professional billing and various sites of care/service is preferred.

• Awareness of value-based care and utilization management is preferred.

• Understanding of data systems and the ability to adapt to changes in data architecture.

• High-speed internet connection exceeding 10 Mbps at home.

• Capability to undergo identity verification, a comprehensive background check, in-person I-9 verification, and potentially a drug screening prior to employment.

🏝️ Benefits

• Work/life balance.

• Flexible work arrangements.

• Autonomy to achieve tasks effectively.

• Comprehensive benefits package, including health insurance for eligible employees.

• Requirement of high-speed internet over 10 Mbps at home.