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Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.
Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.
Join Evolent for the mission. Stay for the culture.
What You’ll Be Doing:
What you’ll be doing :
This individual will spearhead the requirements management for implementation projects across our client and Evolent organizations. By driving Evolent's mission, they will play a pivotal role in delivering our value-based strategy with partners and contribute to dynamic initiatives that propel the growth of our department and team.
You’ll collaborate with IT, product, engineering and business stakeholders and external partners on one of our most innovative and exciting initiatives.
The day-to-day :
Clearly define requirements, process flows, use cases, and acceptance criteria for CMS and Commercial programs.
Facilitate communication between business/IT teams, developers, and external stakeholders.
Identify, document, and analyze discrepancies and anomalies within automated data reconciliation and disputed data
Document business and system requirements standards when new system enhancements or engineering changes are required. Maintain standard templates and support ongoing maintenance
Develop a deep understanding of end user outputs, platform development & configuration, multisystem functional requirements, business rules, and leverage that knowledge to improve processes, recommend solutions, enhance team performance, and drive progression of client objectives
Prioritize mitigation efforts for action items, risks, and issues.
Analyze and address process and software gaps.
Experience you’ll bring :
Bachelor’s degree or equivalent experience.
Able to own and write the Business Requirement Document (BRD) independently for any given domain function with minimal assistance
5-8+ years of IT and / or business experience in an HMO / PPO Claims, Medicaid, Medicare and / or managed care healthcare environment
Knowledge of the Affordable Care Act, HMO and managed care principles including Medicaid and Medicare regulation
Extensive experience with the System Design Life Cycle (SDLC)
Experience with EDI X12 structure and syntax rules; chiefly with 834 files
Superior root cause analysis skills, including corrective action planning and ability to provide documentation to support analysis
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. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.
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 recruiting@evolent.com for further assistance.
The expected base salary/wage range for this position is $$100,000 - $125,000. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.
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For more insights about Evolent Health, click on Life At Evolent (https://www.evolent.com/) to learn more!
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