Associate Director, Medical Economics

Job Description

It’s Time For A Change...

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. We bring our whole selves to work and we’re driven to make a difference every day, from the work we do in our roles to the charitable endeavors we support. We believe in starting by listening, communicating with candor, fostering inclusion, and owning the opportunity. We respect and celebrate individual talents and team wins. Whether we’re wearing scrubs, jeans or our finest work-from-home chic, we have fun, work hard and make time to help others.

Are we growing? Absolutely. We have seen about 30% average growth over the last three years. Are we recognized? Definitely. We were named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016, 2017, 2018 and 2019 and are proud to be recognized as a leader in driving diversity, equity, and inclusion (DE&I) efforts. Evolent achieved a 100% score on the 2020 Human Rights Campaign's Corporate Equality Index, making us one of the best places to work for LGBTQ+ employees. We were also named on the Best Companies for Women to Advance List 2020 by Parity.org and we publish an annual Diversity Report to share our progress on how we’re building an equitable workplace and performing on various metrics. 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.

New Century Health merged with Evolent Health in 2018 and continues to guide transformative change in specialty care management as an Evolent company. Within the Evolent ecosystem of provider-centric solutions for value-based care, our New Century Health team focuses on cost and quality improvement for oncology and cardiology specialty care. With more than 15 years of proven results, New Century Health generates insights and drives cutting edge innovation through its clinical capabilities and deep appreciation of health care informatics, physician management and health care technology systems development. Together, Evolent and New Century Health are harnessing the power of our combined organizations to improve the health of the nation. Join the New Century Health team and put your passion to work for transforming the U.S. health care landscape for patients, providers, and payers.

Who You’ll Be Working With:

The Associate Director, Medical Economics 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. This role supports both Medical Cost Management activities as well as Business Development efforts.

What You’ll Be Doing:

• Analyzing both internal and external datasets for client pricing, medical cost management, operational reporting, and general financial analysis
• Forecasting costs, investigating utilization trends, and creating financial models using claims and other healthcare data
• Developing descriptive and multivariate analytic algorithms, statistical models, and other innovative approaches to investigate problems, detect patterns, and recommend solutions
• Using programming skills to explore, examine and interpret large volumes of data in various forms to complete deliverables
• Collaborating with peers and other teams to gather requirements and develop action plans to complete time sensitive projects more efficiently/effectively as well as identify opportunities for improving the reliability and validity of analytic reports
• Developing presentation materials that effectively summarize results for internal and external stakeholders
• Analyzing prospective and current client utilization data to identify utilization trends, calculate cost of healthcare, and identify opportunities for New Century Health to add value to customers
• 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, creating data reports/dashboards using a variety of performance metrics
• Serving as a subject matter expert across multiple technical and/or business domains
• Managing and/or mentoring and coaching junior analysts with tasks noted above

The Experience You’ll Need (Required):

• 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 3 years of professional experience in claims-based healthcare analytics with a payer, provider, vendor, or related healthcare consulting entity
• Strong proficiency with SQL, SAS, and Microsoft Excel
• 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
• Ability to work independently with limited oversight

Finishing Touches (Preferred):

• Master's Degree, especially with a quantitative focus (e.g., data science, machine learning, statistics, mathematics, computer science, biostatistics or engineering)
• 3+ years of Healthcare economics experience
• Experience in biostatistics
• Prior people management experience
• Knowledge of actuarial reserving methodologies
• Working knowledge of healthcare claims; specifically, differences between institutional vs professional billing and various sites of care/service
• Familiarity with healthcare reimbursement methodologies and calculations such as DRGs, Revenue Codes, CPT Codes, RVUs, bundled payments, etc.
• 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
• Experience with other languages/platforms such as Python, R, SQL, Hadoop, AWS, ArcGIS
• Experience with BI tools (e.g., Tableau, Power BI.), Visual Basic, and Microsoft PowerPoint

Technical requirements:

Currently, Evolent employees work remotely temporarily due to COVID-19. As such, 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. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

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. Evolent Health maintains a drug-free workplace.