Director, Risk Analytics

Your Future Evolves Here

Our Risk Analytics team offers candidates the opportunity to support the evolution of value-based care across all lines of business by collaborating directly with our health plan partners.

We are advocates for creating patient value and demonstrate this by ensuring that our risk-based financial arrangements are equitable and sustainable. We are pioneers in supporting the development of new innovative patient solutions through modeling and insights empowered by data.

Collaboration Opportunities: 

This individual will serve as a leader in the Performance Suite Risk Analytics team at Evolent. This role is primarily focused on leading a team supporting analytics for evaluating financial/quality performance and complex financial reconciliations with our risk-based partnerships. This individual will partner closely with executives across finance, program innovation, actuarial, and account management.  

What You Will Be Doing:

• Key leader of the analytics partnership with Client, & Product  Finance, and Actuarial teams to outline strategic approach for current risk partnerships, various value-based care models and financial/quality/quality-based metrics and provide discovery and product design analytical support.
• Serving as strategic owner of our analytics capabilities and processes related to evaluating performance with our capitated risk partnerships including cost & use projections, financial reconciliations, and providing insight into utilization drivers.

• Analyze performance capitated performance-based risk partnerships, focusing on cost and use trends, and estimating Evolent’s ability to reduce costs and improve quality.

• Assisting in the development of budgets and forecasts for each client and packaging key insights for tracking performance.
• Leading and facilitating interactions with existing customers in a manner that fosters trust in Evolent’s expertise and a spirit of collaboration, including presenting on cost and use trends during quarterly performance reviews.
• Collaborating with internal/external business customers to understand their problems and objectives, solve business questions, and help them to achieve goals by performing statistical analysis, developing analytic models, and creating data reports/dashboards using a variety of performance metrics.
• Partnering with other analytical, product, and IT leaders in assessing new and existing analytical tools and continuously improving analytical processes.
• Managing, mentoring, and coaching members of the team.

• Setting clear goals and objectives using metrics to measure performance while holding staff accountable.
• Develop models to quantify and articulate value.
• Communicate actionable conclusions from analyses to executive internal/external audiences.
• Extract, manage, and analyze claims and operational data using industry-standard metrics.

The Experience You’ll Need (Required and Preferred):

·        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).

·        At least 5 years of professional experience in claims-based healthcare analytics with a payer, provider, vendor, managed care, or related healthcare consulting entity.

·        Extensive knowledge of healthcare claims; specifically, differences between institutional vs professional billing and various sites of care/service.

·        Previous Experience with healthcare reimbursement methodologies and calculations such as Fee for Service, value-based care approaches, bundled payments, etc.

·        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 to solve problems; ability to translate between business needs and analytical needs.

·        Exceptionally strong analytical abilities, with track record of identifying insights from quantitative and qualitative data.

·        Prior people management experience.

·        Ability to work independently with limited oversight.

To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration.

Technical Requirements:

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.

Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. If you need reasonable accommodation to access the information provided on this website, please contact [email protected] for further assistance.