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Job details
Job type full-time
Full 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 deliveredOur pursuit of this mission is the driving power that brings us to work each dayWe believe in embracing new ideas, testing ourselves and failing forwardWe respect and celebrate individual talents and team winsWe have fun while working hard and evolenteers often make a difference in everything from scrubs to jeans.
Are we growing? absolutelyWe have seen about 30% average growth over the last three yearsAre we recognized? definitelyWe 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 important diversity and inclusion (d&i) efforts: evolent achieved a 95% score on its first-ever submission to the human rights campaign's corporate equality index; was named on the best companies for women to advance list 2020 by parity.org; and we publish an annual diversity and inclusion annual report to share our progress on how we’re building an equitable workplaceWe recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each dayIf you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a missionJoin a mission with a company behind it.
Position summary
Evolent health services is looking for a dynamic and strategic senior director level domain technical lead, claimsThis role will report directly to the vp of evolent’s domain technical team and provide the vital link between business and technical functions to ensure our claim operation strategy is infused into the entire solution lifecycle, from requirements gathering through design, testing, deployment and adoptionThe claim domain consists of several key areas of ehs operations (claims, configuration, provider data management, payment integrity, authorizations and encounters)As a claims domain technical lead, this individual will consult on end to end operational and technical process solutions as part of implementation delivery and product strategy.
What you’ll be doing:
Serve as key consultative point of contact between business and technology teams, facilitating and advising on strategic solutions focused on operational efficiency and cost containment.
Transform visionary thinking into aligned action at all levels of the organization, with a focus on sustainable and cost-effective innovation while maintaining excellence in operations.
Effectively partner with implementation delivery teams and play advisory role related to partner implementation delivery and optimization.
Identify technical solutions and improvements for existing processes, develop business requirements and cases to promote those solutions and improvements, and work with the product team to deliver those requirements and solutions.
Internally, build consensus, a sense of urgency and commitment to driving resultsAct as a change agent within the organization.
Evaluate new systems, potential vendor partners, and models to help to improve performance and efficacy of evolent health services.
Foster an environment that stimulates open communication, creativity, imagination and engenders a team spirit in solving problems and identifying and capturing new solution and business strategies.
Contribute to maintaining a strategic product roadmap to ensure appropriate measures are used to prioritize technical/systems projects based on client requirements, quality improvement, regulatory requirements, and potential roi.
Collaborate with clients and external vendors effectively to optimize current and future solutions to achieve or maintain efficiencies.
Perform other duties and projects as assigned.
Desired outcomes
Play a key role in improving client experience, as well as continue to execute on evolent health services strategy.
Strengthen dynamics and be a conduit of continuous communication between domain technical team, business operational leadership, and product teams.
Identify and facilitate solutions to improve areas of the business where operational overhead and efficiency require optimization.
Lead improvements with implementation delivery modeling and execution.
Create and drive the adoption of innovative strategy that pushes the status quo and are anchored in corporate values.
The experience you’ll need (required):
Bachelor’s degree in business management/administration, it, healthcare related discipline or business-related discipline
10+ years of progressive experience within managed care organization, third-party administrator, or other healthcare entity
5+ years’ experience at a management level position
Ability to easily manage and be flexible to fluctuations in demand of work and growth; effectively manage by reporting and strategizing on resource needs.
Strong communication skills (both written and oral)
Strong analytical and organizational skills
Ability to work collaboratively across partner/organizations
An innovative thought leader who consistently contributes new ideas that will improve and enhance the success of the organization and will challenge conventional thinking.
Outstanding communication and organizational skills necessary to present powerful conceptual frameworks in combination with compelling and supporting analytical facts necessary to introduce new initiatives.
A high-energy individual who is disciplined and focused, and yet viewed by colleagues and subordinates as a very positive, genuine personalitySomeone who is clearly focused on doing what is in the best interest of the enterprise.
Hands-on professional who is a natural leader, adviser, consultant and strategist with the demeanor, business maturity, intellect and integrity required to establish immediate credibility.
High impact, low ego professional who thrives in a team setting, motivated by the mission of the larger organization.
Technical requirements:
Currently, evolent employees work remotely temporarily due to covid-19As 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 routerThese at-home technical requirements are subject to change with any scheduled reopening 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.
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Evolent Health
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