[Remote] Analyst, Performance Suite Analytics

Note: The job is a remote job and is open to candidates in USA. Evolent partners with health plans and providers to improve outcomes for patients with complex health conditions. The Analyst, Performance Suite Analytics will utilize analytic tools to address business challenges and support decision-making processes that impact the organization and patient health.

Responsibilities

• Utilizes and develops analytic tools to solve complex business challenges as well as support decision making that can have a considerable impact on the organization and patient health
• Support the Medical Cost Management activities, working in a Medical Economics team that supports Business Development and new product efforts
• 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

• 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)
• 1-2 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)
• Master's 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

Benefits

• Comprehensive benefits (including health insurance benefits)

Company Overview

Company H1B Sponsorship