Analyst, Provider Data Management

Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference working in everything from scrubs to jeans.

Are we growing? Absolutely and Globally. In 2021 we grew our teams by almost 50% and continue to grow even more in 2022. Are we recognized as a company you are supported by for your career and growth, and a great place to work? Definitely. Evolent Health International (Pune, India) has been certified as “Great Places to Work” in 2021. In 2020 and 2021 Evolent in the U.S. was both named Best Company for Women to Advance list by Parity.org and earned a perfect score on the Human Rights Campaign (HRC) Foundation’s Corporate Equality Index (CEI). This index is the nation's foremost benchmarking survey and report measuring corporate policies and practices related to LGBTQ+ workplace equality.

We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.

What You’ll Be Doing:

What You’ll Be Doing:

The Analyst - Operations, Provider Data Management will be a dynamic role that will encompass overall support and maintenance of provider data. This individual will play a critical role in executing Evolent’s mission by working directly with our partners to ensure a focus on quality and execution of target metrics. This position reports to the Director. Duties will include:
• Maintenance of provider data within the claims processing system
• Managing credentialing variables and demographics and contract or fee schedule assignments based on provider updates submitted by clients
• Work with other departments to identify and resolve problems leading to incorrect provider data
• Work and troubleshoot claims that are suspended in provider data work queues or are escalated via ticket from internal or external partners • Determine and document root cause analysis related to data quality errors and recommend remediation activities
• Analyzes data from conceptualization through presentation and, use of presentation software, and strong communication skills
• Integrity and discretion to maintain confidentiality of member’s HIPAA data
• Strong analytical ability necessary to work, discover and outline systems-related issues on own as well as within a team
• The ability to take the lead on projects and recommend and implement process to complete work • Establishing and maintaining excellent relationships, internally and externally

Key competencies/skill/success factors:
• Lives the values: Communicate with candor, Start by Listening, Foster Inclusion, and Own the Opportunity
• Experience working within a health plan managed care organization, provider-operated healthcare environment, or third-party administrator
• Demonstrated exceptional active listening and communication skills (Both verbal and written)
• Understands and can work in a production environment in which performance is tied to operational metrics with a focus on updating provider data with accuracy and completing quality review in a timely manner
• Experience in systems and languages related to database lifecycle management such as SQL Server, Visual Basic, etc.
• Detail-oriented with good organizational skills
• Ability to work in an agile space and adapt to fluctuating situations
• Takes initiative and works independently with the ability to time manage and reprioritize tasks/projects as appropriate
• Extensive knowledge of PCs and related software applications, such as Word, PowerPoint, Excel, Project Preferred Experience We Look For: Associates Degree or equivalent, Required Bachelor’s degree in Computer Science, Statistics, Mathematics or related field preferred. 4-6 years of experience in Claims, Provider/US healthcare Industry

Mandatory Requirements:

We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

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Evolent Health 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.