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Evolent Health Director, Medical Economics in Des Moines, Iowa

Your Future Evolves Here

New Century Health (NCH) has been transforming the delivery of specialty care and driving radical cost and quality improvement across the member journey for patients with cancer and cardiovascular disease. As part of Evolent Health, we are on a bold mission to change the health of the nation by changing the way health care is delivered. Evolenteers make a difference wherever they are, whether it is at a medical center, in the office, or while working from home across 48 states. We empower you to work from where you work best, which makes juggling careers, families, and social lives so much easier. Through our recognition programs, we also highlight employees who live our values, give back to our communities each year, and are champions for bringing their 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.

Why We’re Worth the Application:

  • We continue to grow year over year.

  • Recognized as a leader in driving important diversity, equity, and inclusion (DE&I) efforts (https://www.evolenthealth.com/diversity) .

  • Achieved a 100% score two years in a row on the Human Rights Campaign's Corporate Equality Index making us a best place to work for LGBTQ+ equality.

  • Named to Parity.org’s 2020 list of the best companies for women to advance (https://www.evolenthealth.com/about-us/press-releases/8579/evolent-health-named-to-parity.org%E2%80%99s-best-companies-for-women-to-advance-list-2021) .

  • Continued to prioritize the employee experience and achieved an 87% overall engagement score on our last employee survey.

  • Published an annual DE&I report (https://dev.evolenthealth.com/sites/default/files-public/Evolent%20Health%202020%20DE%26I%20Annual%20Report.pdf) to share our progress on how we’re building an equitable workplace.

What You’ll Be Doing:

Who You’ll Be Working With:

The 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 Medical Cost Management activities and a variety of internal operations functions; partnering with Business Development, Finance/Accounting, Actuarial, EDWBI, Clinical, Performance Solutions and Partner Delivery.

What You’ll Be Doing:

  • Key leader of the analytics partnership with Business Development & Product teams to outline strategic approach for various Sales and Product pursuits

  • Serving as strategic owner of our analytics capabilities and processes related to the development/underwriting of capitated risk proposals including cost & use projections, trend selection/development, and estimation of NCH’s ability to reduce cost and improve quality

  • Leading a team in the analysis and interpretation of cost and utilization data (medical and pharmaceutical) to explain potential upside/downside risks of a given arrangement/proposal.

  • Develop analytical models and synthesize complex analyses into succinct presentations for internal/external buy-in

  • Assisting in the development of budgets and forecasts for each new business relationship and packaging key insights for tracking performance.

  • Collaborating with partner departments to establish best practice processes and efficient workstreams from end to end of the proposal process in terms of prospecting clients, qualifying/outlining a suitable proposal, data intake, analysis, proposal development/communication, client alignment, contracting, and implementation

  • Using programming skills to explore, examine and interpret large volumes of data in various forms to complete deliverables with minimal oversight

  • Lead and facilitate interaction with customers in a manner that fosters expertise and cooperation

  • 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

  • Managing, mentoring, and coaching analysts with tasks noted above

  • Setting clear goals and objectives using metrics to measure performance while holding staff accountable

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 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 DRGs, Revenue Codes, CPT Codes, RVUs, 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

  • Experience in data mining, advanced/statistical analysis, and data manipulation

  • Knowledge of health insurance financial business cycle, healthcare quality reporting, and benchmarking

  • 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

Finishing Touches (Preferred):

  • Master's Degree, preferably with a quantitative or healthcare focus (e.g. data science, machine learning, statistics, mathematics, computer science, engineering, public health)

  • Previous experience in a medical economics related position within Utilization Management/Clinical Vendor Management functions

  • Knowledge of healthcare underwriting methodologies

  • 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, SAS, Hadoop, AWS, ArcGIS

  • Experience with BI tools (e.g. 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, 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 committed to the safety and wellbeing of all its employees, partners and patients and complies with all applicable local, state, and national law regarding COVID health and vaccination requirements. Evolent expects all employees to also comply. We currently require all employees who may voluntarily return to our Evolent offices to be vaccinated and invite all employees regardless of vaccination status to remain working from home.

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.

Compensation Range: The minimum salary for this position is $105,000, plus benefits. Salaries are determined by the skill set required for the position and commensurate with experience and 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.evolenthealth.com/about-us/life-at-evolent) to learn more!

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