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Evolent Health jobs

- 35 jobs
  • Managing Director, Product Management

    Evolent 4.6company rating

    Evolent job in Columbus, OH

    **Your Future Evolves Here** 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:** Evolent is seeking an experienced Managing Director of Product Management to help Evolent grow by partnering with Payers to deliver solutions across multiple specialties, offering the potential to improve health outcomes and increase affordability. You will be a part of a cross-functional Evolent team that serves as a pivotal strategic partner to health systems and provider practice groups. **Key Responsibilities:** + Drive a Product-focused, Partner-First Implementation Strategy. + Work alongside Evolent's Partner Operations and Strategic Account Teams to create a standard implementation approach across partners and specialties that emphasizes "out-of-the-box" functionality. + Develop strategies for slotting opportunities well in advance of requirement gathering that maximizes both Partner satisfaction and team capacity for discovery and development. + Partner with Evolent Engineering to Streamline Implementations. + Where necessary, partner with Evolent Engineering to define, prioritize, and build and enhance technology that allows for efficient, scalable, and accurate onboarding of new business. + Serve as the voice of the customer to communicate Partner-specific configuration and non-standard requirements to deliver the highest quality integrations between Evolent and Partner. + Develop and Lead a High Performing Team. + Serve as a competent and engaging people-leader across Product Management and Product Owner resources supporting application configuration and client pipeline teams. **Required Qualifications:** + Bachelor's degree required. Master's degree in public health, Healthcare Administration, or a related field preferred. + At least eight years of healthcare technology Product Management experience, ideally in a services-oriented organization. + Strong demonstrated understanding of provider, and payer personas, 'jobs to be done' and practice workflows, with a preference for expertise in UM workflows + Exceptional verbal and written communication skills, with the ability to articulate complex concepts clearly to diverse audiences (clinicians, engineering, administrative staff, leadership). + Experience with scrum and agile methodologies. + Proven experience working closely with Payer customers is required. + Experience with Lean/Six Sigma or other process improvement methodologies in a healthcare setting is preferred. To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration. **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** ************************** **for further assistance.** The expected base salary/wage range for this position is $175,000 - 195,000. 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. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!
    $175k-195k yearly 33d ago
  • SaaS Administrator, Enterprise Applications

    Evolent 4.6company rating

    Evolent job in Columbus, OH

    **Your Future Evolves Here** 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:** The SaaS Administrator is responsible for managing the full lifecycle of SaaS applications across the organization. This includes discovering, optimizing, securing, and governing SaaS usage to maximize business value and ensure compliance. This role also supports administration functions of enterprise platforms including Jira, Confluence, Jira CMDB, Statuspage. **Key Responsibilities:** + Manage the SaaS life cycle: discover SaaS usage, manage SaaS configuration policies, optimize SaaS entitlements, automate SaaS-related employee onboarding and offboarding processes, measure and publish reports on SaaS usage and costs for IT leadership + Collaborate with digital workplace engineering & security teams to establish and document SaaS configuration, security controls, compliance requirements and processes to continually identify vulnerabilities in configuration and noncompliant usage of SaaS apps + Administer and optimize Atlassian platforms (Jira, Confluence, Statuspage, Jira CMDB, JSM Operations, Atlassian Analytics), including migrations, workflow analysis, automation, and integration of third-party apps + Integrate SaaS and enterprise platforms to enable and streamline IT processes (e.g., ITSM, IAM, ITAM) and business workflows, facilitating tool adoption by understanding stakeholder requirements, managing implementations, and conducting testing and User Acceptance Testing (UAT) + Produce usage reports and perform system health checks + Engage with vendors' support teams to resolve platform issues + Create and communicate knowledgebase articles to support IT staff and minimize support overhead + Ensure that the needs of all customers are met accurately and in a timely fashion, as documented in team Service Level Agreements (SLAs) + Continue to improve technical expertise through research and identification of new processes and technical alternatives to resolve problems and/or implement continuous improvement + Adhere to and advocate all requirements of IT Privacy and Security Policies and Procedures + Participate and contribute to project and team meetings. Transfer knowledge, share expertise, and continuously mentor and collaborate with other members of the team **Required Qualifications:** + Bachelor's degree in IT or related field + 3+ years of experience in IT operations, SaaS administration, and supporting datacenter and cloud-based Atlassian applications (Jira, Confluence, Crowd) + Strong analytical, problem-solving, collaboration, and documentation skills + Familiarity with ITSM, IAM, CMDB systems + Experience working with audit, privacy, and security requirements, including SOC2, and HIPAA + Ability to work in a dynamic environment, including the ability to manage and prioritize tasks while maintaining a service-oriented work ethic + Must be very detail-oriented, organized and able to work independently to support multiple complex projects simultaneously in a fast-paced environment + Experience with automation/scripting tools (e.g., PowerShell, Bash, Python) is preferred + Ability to learn new technologies and explain technical issues to diverse audiences is preferred + Relevant certifications, such as ITIL Foundation Certification and Atlassian cloud certifications, are preferred To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration. **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** ************************** **for further assistance.** The expected base salary/wage range for this position is $88,000 - 105,000. 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. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!
    $88k-105k yearly 10d ago
  • Member Engagement Specialist

    Community Care of North Carolina Inc. 4.0company rating

    Remote or Cary, NC job

    The Member Engagement Specialist is responsible for telephonic outreach and screening of identified members based on plan stratification for care management with a call center approach. An experienced and energetic communicator, the engagement specialist is focused on deepening program participation as well as making members aware of CCNC (Community Care of North Carolina) (plan) programs and offerings. The Member Engagement Specialist interacts with members, providers, and other staff to initiate program interventions, document activities, and refer risk appropriate members to professional staff according to protocols. The candidate for this position must have a disposition towards good customer service, be assertive without being aggressive, and always maintain a professional demeanor. The Member Engagement Specialist may work remotely within regions to cover the needs across the state. This is primarily a remote position. Occasional in-person training and travel may be required. Essential Functions Conduct continual telephonic outreach to identified and referred members focused on engaging members with care management services. Receive/retrieve and manage referrals from data reports; clinical care management team members, PCP (Primary Care Provider), or other service providers for efficient screening and linking members with care management. Complete and document member screenings tools and refer clinical needs to most appropriate clinical care management team member for assessment and follow up. Schedule members for face-to-face or telephonic encounters for care management follow up. Meet monthly productivity and role expectations. Complete all assignments within expected timeframes. Notify supervisor promptly of any issues with receiving or sending referrals, making timely care management assignments, or issues with carrying out any other duties assigned. Collaborate with the Care Team to address barriers and create efficiency with processes. Abide by department guidelines, company policies, and HIPAA regulations. Perform all other duties as requested. Attend departmental and corporate meetings. Understand and uphold CCNC goals, objectives, and standards. Qualifications High School/GED. Prior telephonic call center experience desired Minimum of two years previous work experience, preferably in a health care setting Healthcare experience and medical terminology knowledge highly preferred Bilingual preferred Managed care experience a plus Knowledge, Skills, and Abilities Computer skills required including various office software and the internet; experience with MS Office software preferred Strong Initiative Performance metric driven and productivity mindset Strong oral and written communication proficiency Attention to detail Organizational and Time Management Skills Strong Interpersonal Skills Critical Thinking Skills Resourceful - Able to shift strategy or approach in response to the demands of a situation Team-oriented Adaptable - Responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives Motivational Interviewing Skills Knowledge of Care Management Principles Ability to work independently and to use sound judgment when needed Multi-tasking Abilities Outgoing and energetic attitude Respectful customer service skills Ability to provide information in a manner that is culturally and linguistically appropriate Knowledge of and experience working in member or clinical data systems Working Conditions Routinely there may be some minor physical inconveniences or discomforts in the work setting, including sitting for moderate periods of time and repetitive wrist motion Must be able to utilize office equipment, computer, keyboard, and phone with or without assistive devices Repetitive wrist motion and occasional lifting/carrying of up to 25 pounds The job environment is a home environment Travel using personal vehicle may be required within the region and/or the State The job environment can be intense as high volume, repetitive work is an expectation
    $30k-38k yearly est. Auto-Apply 38d ago
  • Senior Communications Specialist

    Altarum 4.5company rating

    Remote job

    We're excited to share an upcoming opportunity (pending a contract award) and are building a pipeline of qualified candidates in advance. Hiring is expected to begin once the final award is confirmed, anticipated within the next 2-3 months. As a Senior Communications Specialist (Senior Account Executive), you'll lead projects across the research, strategy, and execution phases, contributing substantively to solution design and ensuring the quality of work produced by more junior team members. You'll manage up, down, and across teams, helping to sustain client relationships while supporting discrete projects that involve analysis, research, and trend identification. In this role, you'll be part of Palladian Partners, Altarum Enterprise's full-service marketing and communications team, collaborating with colleagues across disciplines to deliver innovative, high-impact solutions for our clients.What You'll Do Contribute substantively to planning, research, writing, and strategy development Consistently produce high-quality correspondence, communication materials, reports, and other types of materials for internal audiences and clients Communicate directly with clients and external partners to implement strategies and tactics Develop/review project plans and track project activities, timelines, and quality reviews Manage social, paid, and traditional media outreach, including strategy, content development, and analytics Contribute substantively to content creation by communicating ideas and working with integrated project teams of designers, writers, and digital strategists to develop creative and digital assets, including videos, websites, infographics, and more Provide client service support with regular monitoring and reporting, managing timelines, proofreading, and client touchpoints Ensure quality work product of more junior team members Collaborate with other team members to address challenges and solve problems proactively Attend and contribute substantively to meetings, including taking actionable notes in both internal and external meetings; assist with scheduling and logistics Participate in new business process including research and proposal preparation Contribute to organic growth What You'll Bring Strong written and verbal communication skills Excellent interpersonal and multidisciplinary project skills Ability to work collaboratively on a team and with key stakeholders and clients Action-oriented, organized, proactive, and adaptable approach to project management Proven ability to meet deadlines and work on multiple projects simultaneously Demonstrated attention to detail and commitment to customer service Education and Experience Bachelor's degree with 3+ years of work experience Master's degree or PHD a plus. Government contracting and/or agency experience strongly preferred Media relations experience is a plus Where You'll Work Remote with occasional in-person collaboration days If you're near one of our offices (Arlington, VA; Silver Spring, MD; or Novi, MI), you'll join us in person one day every other month (6 times per year) for a fun, purpose-driven Collaboration Day. These days are filled with creative energy, meaningful connection, and team brainstorming! Non-local employees may be asked to join us on these days at an approved co-working space. Work Eligibility & Requirements Candidates must be currently eligible to work in the United States; sponsorship is not available. All work must be performed within the continental U.S. for the duration of employment, unless required by contract. Ability to work core hours aligned with Eastern Time, unless otherwise approved by your manager. Remote employees must maintain a dedicated, ergonomically appropriate workspace free from distractions, with reliable internet and a mobile device that supports efficient work. Altarum is a nonprofit organization focused on improving the health of individuals with fewer financial resources and populations disenfranchised by the health care system. We work primarily on behalf of federal and state governments to design and implement solutions that achieve measurable results. We combine our expertise in public health and health care delivery with technology development and implementation, practice transformation, training and technical assistance, quality improvement, data analytics, and applied research and evaluation. Our innovative solutions and proven processes lead to better value and health for all. Altarum is an equal opportunity employer that provides employment and opportunities to all qualified employees and applicants without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, or any other characteristic protected by applicable law.
    $67k-89k yearly est. Auto-Apply 19d ago
  • Senior Analytics Engineer - BI & Data Visualization

    Altarum 4.5company rating

    Remote job

    Altarum | Data & AI Center of Excellence (CoE) Altarum is seeking a Senior Analytics Engineer - BI & Data Visualization to serve as the “last-mile translator” between advanced data systems and the decision-makers who rely on them. In this pivotal role, you'll turn raw data pipelines, evaluation outputs, causal inference models, and ML predictions into trusted, actionable insights for federal and state partners. If you love semantic modeling, BI design, dbt craftsmanship, and telling complex stories with data, this role puts you at the center of Altarum's insight delivery ecosystem. What This Role Blends Analytics Engineering (dbt, SQL, semantic modeling) Data Visualization Leadership (Power BI, UX, narrative design) ML & Evaluation InterpretabilityShared-services enablement across all Altarum divisions You will set the standards, build the templates, and create the reusable metrics that power insights organization-wide.What You'll Do Own dbt projects across public health, behavioral health, Medicaid, maternal/child health, and SDOH domains. Create and manage semantic models, data contracts, macros, and versioned transformations. Define and govern reusable metrics: dimensions, denominators, time logic, risk adjustment, and composite measures. Build star schemas and conformed dimensions optimized for Power BI, including RLS and deployment pipelines. Work closely with Data Platform Engineers to ensure pipelines are analytics-ready and performant. Data Visualization & Storytelling Lead design and delivery of executive-ready dashboards using Power BI, with strong UX and accessibility (Section 508). Build dashboards in Power BI (primary) with optional support for Tableau/Looker. Translate complex methods-equity stratifications, quasi-experimental results, small-area estimation, NLP outputs-into policy-ready visuals. Create ML explainability dashboards (SHAP, LIME, bias metrics, drift/calibration). Partner with creative and UX teams to produce visually compelling and context-appropriate designs. Quality, Governance, & Standards Implement rigorous validation and BI QA (dbt tests, performance testing, dashboard monitoring). Maintain a centralized metrics catalog, semantic dictionary, and visualization standards. Manage BI versioning, documentation, and data lineage in alignment with federal requirements. Develop Power BI themes, navigation patterns, KPI templates, and reusable dbt + BI starter projects. Enablement & Scale Develop and deliver training for Analytics Engineering and BI best practices. Provide pairing sessions, workshops, and visualization coaching across divisions. Publish accelerator packages (dbt bundles, semantic models, Power BI templates) to improve delivery speed. Instrument BI usage analytics and run structured feedback cycles with stakeholders. Success Metrics (KPIs) Time-to-dashboard ≤ 4 weeks from modeled data to stakeholder review Dashboard adoption, usage, and stakeholder satisfaction Increased metric standardization and catalog coverage Reuse of templates and semantic models across ≥3 divisions What You'll Bring 5-8 years as an Analytics Engineer, BI Lead, or similar role Strong proficiency in SQL and dbt (models, tests, macros, documentation, CI/CD) Mastery of Power BI, including DAX, Power Query (M), semantic models, dataflows, RLS, and deployment pipelines Strong experience with data modeling, dimensional design, and performance tuning Ability to present analytics solutions and incorporate customer feedback Strong Git workflows, code review, and documentation discipline Preferred: Familiarity with public health or Medicaid/Medicare domains and equity or evaluation methods Experience integrating ML outputs into dashboards (SHAP, drift, feature importance) Python/R for analysis or geospatial mapping (ArcGIS/QGIS) Knowledge of FHIR-to-analytics models, USCDI+, or TEFCA concepts Experience with AWS-based data sources (Redshift, Athena, S3/Parquet) or Databricks/Snowflake Experience developing BI/analytics training or design systems Power BI for Government experience (strongly preferred, not required) Logistical Requirements At this time, we will only accept candidates who are presently eligible to work in the United States and will not require sponsorship. Our organization requires that all work, for the duration of your employment, must be completed in the continental U.S. unless required by contract. If you're near one of our offices (Arlington, VA; Silver Spring, MD; or Novi, MI), you'll join us in person one day every other month (6 times per year) for a fun, purpose-driven Collaboration Day. These days are filled with creative energy, meaningful connection, and team brainstorming! Must be able to work during Eastern Time unless approved by your manager. Employees working remotely must have a dedicated, ergonomically appropriate workspace free from distractions with a mobile device that allows for productive and efficient conduct of business. Altarum is a nonprofit organization focused on improving the health of individuals with fewer financial resources and populations disenfranchised by the health care system. We work primarily on behalf of federal and state governments to design and implement solutions that achieve measurable results. We combine our expertise in public health and health care delivery with technology development and implementation, practice transformation, training and technical assistance, quality improvement, data analytics, and applied research and evaluation. Our innovative solutions and proven processes lead to better value and health for all. Altarum is an equal opportunity employer that provides employment and opportunities to all qualified employees and applicants without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, or any other characteristic protected by applicable law.
    $82k-110k yearly est. Auto-Apply 28d ago
  • Member Care Coordinator

    Community Care of North Carolina Inc. 4.0company rating

    Remote or Raleigh, NC job

    The Member Care Coordinator position is a non-clinician role that works in collaboration with the Care Management staff and/or quality improvement staff to support the multi-disciplinary team approach of patient care by meeting key performance indicators (closing care gaps, reducing hospitalizations, readmissions, ED utilization, and PMPM costs) and other organizational mandates as designated. The Member Care Coordinator may work remotely within regions to cover the needs across the state and/or may work on site at CCPN practices. Member Care Coordinators may directly assist members in improving their ability to improve their health outcomes. They also help design and implement systems to ensure the smooth operation of office functions and to support the Care Team. Member Care Coordinators may also work directly with assigned practices to assist them in addressing care gap closure under the direction of Provider Relations Representatives. This is primarily a remote position. Occasional in-person training and travel may be required. Essential Functions Receive and document all referrals from various sources into the Care Management documentation platform Verify eligibility and demographic information May complete Health Risk Screenings as needed Assist with mailing of educational materials, consent forms or other documents to the member as necessary Assist with referrals on behalf of the Care Management team Provide information for access and coordination of resources Assist member with care coordination and health care system navigation Provide culturally appropriate health education and information Provide general education and social support Advocate for members Identify care gaps and perform outreach to members in attempt to close gaps as requested Assist practice to submit supplemental data to health plans to provide documentation of gap closure as requested; assist with scheduling medical appointments and transportation as needed Assist to address with Social Determinants of Health as needed Access multiple EHR's to obtain and upload into the care management platform Access to Hospital/Data or Electronic Medical Record system will be required, as necessary Notify supervisor promptly of any issues with carrying out any duties assigned Adhere to CCNC Privacy and Security policies to ensure that patient and company data is properly safeguarded Abide by department guidelines, company policies, and HIPAA regulations Perform other duties that assist in keeping the operations organized and functional Attend Departmental and corporate meetings, local and regional training, or other events as required Understand and uphold CCNC goals, objectives, and standards Travel using a personal vehicle will be required within the region and/or the State Qualifications High school diploma or GED required; or Licensed Practical Nurse 2-4 years minimum experience in a health care setting required 2- or 4-year degree in health-related field preferred Bilingual preferred Maintain a valid driver's license with current auto liability insurance Knowledge, Skills, and Abilities Knowledge of and experience working in patient or clinical data systems Computer skills required including various office software and the internet; experience with MS Office software preferred Knowledge of state and federal benefits system Excellent communication skills - oral and written Proficient Motivational Interviewing skills Organizational and time management skills Sensitivity to diversity of cultures, language barriers, health literacy and educational levels Knowledge of medical terminology Responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives Able to shift strategy or approach in response to the demands of a situation Working Conditions The job environment is primarily an office or home environment. Multiple contacts are required with various members, providers, multi-payer systems and community partners to ensure coordination of services; exposure to general office and household conditions, as well as communicable disease could occur Routinely there may be some minor physical inconveniences or discomforts in the work setting, including sitting for moderate periods of time Must be able to utilize office equipment, computer, keyboard and phone with or without assistive devices Repetitive wrist motion and occasional lifting/carrying of up to 25 pounds Travel will be required within the region and/or the State
    $29k-41k yearly est. Auto-Apply 12d ago
  • Clinical Reviewer, Nurse (Medical Oncology)

    Evolent Health 4.6company rating

    Remote Evolent Health job

    Your Future Evolves Here 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: Your Future Evolves Here 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: The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed within the RN/LVN/LPN scope of practice, under the Medical Director's direction, using independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum and working in concert with the health care delivery team to maintain high-quality, cost-effective care delivery. Perform pre-certification utilization reviews of Oncology treatment requests Determines medical necessity and appropriateness of services using clinical review criteria. Accurately documents all review rationales and determinations. Appropriately identifies and refers cases that do not meet established clinical criteria to the Medical Director. Appropriately identifies and refers quality issues to UM Leadership. Collaborates with physicians and other providers to facilitate the provision of services throughout the health care continuum. Performs accurate data entry. Communicates appropriate information to other staff members as necessary/required. Participates in continuing education initiatives. Availability on some weekends and holidays may be required. Performs other duties as assigned. The Experience You'll Need (Required): Registered Nurse or Licensed Practical/Vocational Nurse with a current, unrestricted license. High School Diploma or equivalent required Minimum of three years of direct clinical patient care (acute, inpatient, or critical care setting); strongly prefer direct Oncology experience. Strong computer skills, including MS Office Suite Strong interpersonal, oral, and written communication skills. Availability for weekend holiday rotation. Finishing Touches (Preferred): Experience with clinical decision-making criteria sets (i.e., Milliman, InterQual) Minimum of one year of experience with medical management activities in a managed care environment UM/UR experience Clinical experience in Oncology, ICU, ED, or other critical care environment Remote work experience To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration. 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 ********************** for further assistance. The expected base salary/wage range for this position is $32-$37 /hr. 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.
    $32-37 hourly Auto-Apply 20d ago
  • Technical Project Manager

    Altarum 4.5company rating

    Remote job

    We are seeking a highly organized and technology proficient Technical Project Manager to support and lead requirements gathering, Agile delivery, and project coordination across multiple technology initiatives within our Public Health Systems division. This role blends product management activities such as gathering business requirements and defining user stories with core project management responsibilities, including JIRA management, stand-up/sprint coordination, and cross-team communication. The ideal candidate can translate business needs into actionable development tasks, coordinate Agile workflows, and communicate clearly with technical teams, public health partners, and internal stakeholders. This position offers a strong growth path into senior technical project management or product management roles within a mission-driven, collaborative environment. Responsibilities Product & Requirements Management Lead discussions with clients, stakeholders, and internal teams to gather, refine, and document business requirements for new implementations and enhancements. Translate requirements into Epics, User Stories, acceptance criteria, and process workflows. Maintain and organize product documentation, including requirements, user journeys, and feature definitions. Support creation and maintenance of PRDs, roadmaps, and traceability documentation as needed. Project Coordination & Agile Delivery Plan, schedule, and track project deliverables, sprints, and milestones. Manage resource allocations and overall project financial forecasting Own and maintain JIRA boards, including backlog grooming, prioritization, sprint setup, and work tracking. Facilitate Agile ceremonies such as daily standups, sprint planning, sprint reviews, and retrospectives. Monitor timelines, dependencies, and risks, escalating blockers when needed. Document meetings, decisions, and follow-up actions to ensure alignment across teams. Client and Stakeholder Support Prepare updates, release notes, sprint summaries, and client communications. Support demos, walkthroughs, and stakeholder presentations. Respond to inquiries, document requests, and ensure clear routing to the appropriate technical or business team. Technical and Operational Support Collaborate with developers, QA, and DevOps to ensure requirements are fully understood and implemented correctly. Participate in testing and validation activities to confirm acceptance criteria are met. Assist in UAT coordination, release readiness checks, and post-launch activities. Help triage issues, validate reported problems, and support Help Desk processes when relevant. Reporting and Documentation Prepare project status reports, milestone summaries, and performance metrics. Maintain accurate documentation of requirements, deliverables, sprint outcomes, and project history. Support cross-team reporting on progress, resource use, and upcoming priorities. Qualifications Bachelor's degree in information technology, Business Administration, Computer Science, Public Health, or related field (or equivalent experience). Three to five years of experience in technical project management, product coordination, business analysis, or related hybrid roles. Strong understanding of Agile delivery, backlog management, and software development workflows. Ability to translate business needs into clear and actionable documentation (Epics, User Stories, acceptance criteria). Excellent written and verbal communication skills across technical and non-technical audiences. Proficiency with project management and documentation tools such as JIRA and Confluence. Highly organized, detail-oriented, and comfortable managing multiple concurrent workstreams. Preferred Skills Experience working in environments using Drupal, Moodle, or other content/learning management systems. Familiarity with interoperability standards, EHR workflows, or public health systems. Exposure to Agile/Scrum methodologies or participation in Agile ceremonies. Understanding of software environments (Dev, QA, UAT, Prod) and release cycles. Ability to create process flows, wireframes, or technical documentation is a plus Logistical Requirements At this time, we will only accept candidates who are presently eligible to work in the United States and will not require sponsorship. Our organization requires that all work, for the duration of your employment, must be completed in the continental U.S. unless required by contract. Must be able to work during eastern time unless approved by your manager. Employees working remotely must have a dedicated, ergonomically appropriate workspace free from distractions with a mobile device that allows for productive and efficient conduct of business. Altarum is a nonprofit organization focused on improving the health of individuals with fewer financial resources and populations disenfranchised by the health care system. We work primarily on behalf of federal and state governments to design and implement solutions that achieve measurable results. We combine our expertise in public health and health care delivery with technology development and implementation, practice transformation, training and technical assistance, quality improvement, data analytics, and applied research and evaluation. Our innovative solutions and proven processes lead to better value and health for all. Altarum is an equal opportunity employer that provides employment and opportunities to all qualified employees and applicants without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, or any other characteristic protected by applicable law.
    $65k-90k yearly est. Auto-Apply 39d ago
  • Implementation Engineer

    Evolent 4.6company rating

    Evolent job in Columbus, OH

    **Your Future Evolves Here** 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:** **Job Description** We are seeking a technically strong Implementation Engineer with expertise in data integration to support the full lifecycle of client onboarding and data pipeline development. This role involves configuring systems, resolving implementation issues, and building scalable data workflows using SQL, SSIS, ADF, and Python. **Responsibilities:** + Support the full implementation lifecycle: development, testing, deployment, and go-live. + Troubleshoot and resolve technical issues during implementation to ensure smooth transitions. + Design, build, and maintain data pipelines and ETL workflows using SQL, SSIS, ADF, and Python. + Interpret and implement data models and mappings for integration tasks. + Collaborate with cross-functional teams to translate business requirements into technical solutions. + Monitor and optimize data quality, performance, and reliability. + Maintain technical documentation and provide post-implementation support. **Requirements:** + Bachelor's degree in Computer Science, Software Engineering, IT, or related field. + 5+ years of experience in software implementation, system integration, or data engineering. + Strong proficiency in SQL, SSIS or relevant tool, experience with Azure Data Factory is a plus. + Solid understanding of data models, data mappings, and relational databases. + Familiarity with APIs and cloud platforms (e.g., Azure). + Excellent communication skills with the ability to explain technical concepts to diverse audiences. + Self-driven, detail-oriented, and capable of working independently or in a team environment. To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration. **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** ************************** **for further assistance.** The expected base salary/wage range for this position is $90,000 - 110,000. 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. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!
    $90k-110k yearly 7d ago
  • Visual & Multimedia Designer

    Altarum 4.5company rating

    Remote job

    We're excited to share an upcoming opportunity (pending a contract award) and are building a pipeline of qualified candidates in advance. Hiring is expected to begin once the final award is confirmed, anticipated within the next 2-3 months. As a Visual & Multimedia Designer (Sr. Account Executive - Creative), you'll make substantive contributions across the strategy and execution phases of projects. You'll apply your expertise in visual design and other creative disciplines to develop efficient, effective solutions, ensure high-quality work, and contribute meaningfully to your team. You'll manage up, down, and across teams to accomplish work and help sustain client relationships at the appropriate level. In this role, you'll join Palladian Partners, Altarum Enterprise's full-service marketing and communications team, collaborating with colleagues across disciplines to deliver innovative, high-impact solutions for our clients.What You'll Do Contribute substantively to planning, research, and strategy development for creative projects Consistently produce high-quality designs, correspondence, materials, reports, and other types of information for internal audiences and clients Research and analyze industry and competitor trends and provide insightful recommendations to team and client Contribute substantively to content creation by communicating ideas and working with integrated project teams of strategists and writers to develop assets, including fact sheets, animations, videos, websites, infographics, and more Track assignments and project activities to meet deadlines Collaborate with other team members to address challenges and solve problems proactively Attend and contribute to meetings, including taking actionable notes in both internal and external meetings Participate in new business process including research and proposal preparation Contribute to organic growth What You'll Bring Strong written, verbal, and visual/multimedia communication skills Ability to work collaboratively on a team and with key stakeholders and clients Action-oriented, organized, proactive, and adaptable approach to project management Proven ability to meet deadlines and work on multiple projects simultaneously Demonstrated attention to detail and commitment to customer service Education and Experience Bachelor's degree with 3+ years of work experience in visual & multimedia design Master's degree or PHD a plus Government contracting and/or agency experience strongly preferred Familiarity with federal accessibility standards for digital products a plus Animation and multimedia/video experience preferred Where You'll Work Remote with occasional in-person collaboration days If you're near one of our offices (Arlington, VA; Silver Spring, MD; or Novi, MI), you'll join us in person one day every other month (6 times per year) for a fun, purpose-driven Collaboration Day. These days are filled with creative energy, meaningful connection, and team brainstorming! Non-local employees may be asked to join us on these days at an approved co-working space. Work Eligibility & Requirements Candidates must be currently eligible to work in the United States; sponsorship is not available. All work must be performed within the continental U.S. for the duration of employment, unless required by contract. Ability to work core hours aligned with Eastern Time, unless otherwise approved by your manager. Remote employees must maintain a dedicated, ergonomically appropriate workspace free from distractions, with reliable internet and a mobile device that supports efficient work. Altarum is a nonprofit organization focused on improving the health of individuals with fewer financial resources and populations disenfranchised by the health care system. We work primarily on behalf of federal and state governments to design and implement solutions that achieve measurable results. We combine our expertise in public health and health care delivery with technology development and implementation, practice transformation, training and technical assistance, quality improvement, data analytics, and applied research and evaluation. Our innovative solutions and proven processes lead to better value and health for all. Altarum is an equal opportunity employer that provides employment and opportunities to all qualified employees and applicants without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, or any other characteristic protected by applicable law.
    $55k-71k yearly est. Auto-Apply 20d ago
  • Field Medical Director, Interventional Cardiology (Remote)

    Evolent Health 4.6company rating

    Remote Evolent Health job

    Your Future Evolves Here 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: Job Description Cardiovascular Utilization Management Reviewer (Interventional Cardiologist) Are you ready to make a meaningful impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the delivery of high-value, evidence-based case reviews. Enjoy improved work-life balance while contributing to better health outcomes in an environment that fosters collaboration, continuous learning, and impactful peer-to-peer discussions. What We Offer: A meaningful way to contribute to patient care beyond the clinical setting. Opportunities for collaboration with a dynamic team of physicians, leaders, and clinical professionals. A role that values innovation, continuous improvement, and clinical excellence. This position is 100% Remote and can be completed from any state. Multiple opportunities for a flexible schedule and both part-time and full-time options available. What You'll Do: Provide expert reviews for cardiovascular cases, serving as a specialty-matched expert reviewer for invasive/interventional cardiology cases (e.g., cardiac catheterizations, coronary interventions, endovascular procedures, implantable cardiac devices, etc) that do not initially meet medical necessity guidelines or require further evaluation by a subject matter expert. Conduct peer-to-peer discussions with treating providers to ensure appropriate, high-value care aligned with clinical guidelines. Collaborate with leadership, management, and clinical staff to address complex cases and support decision-making. Act as a key resource for Initial Clinical Reviewers, offering guidance and expertise to ensure the application of best practices. Provides clinical rationale for standard and expedited appeals. Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request. Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner. Participates in on-going training per inter-rater reliability process. May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. Qualifications MD/DO/MBBS Degree Current, unrestricted clinical license in medicine or required specialty Obtaining and maintaining medical licenses in the state you reside, as well as, other state licensure required per business needs Active Board Certification in Interventional Cardiology or may be substituted for one of the following: Active Board Certification in Cardiology and proof of prior board certification in Interventional Cardiology Active Board Certification in Cardiology and proof of active practice as an Interventional Cardiologist for 5+ years Strong clinical, management, communication, and organizational skills Energetic and curious with a passion for quality and value in health care Computer Proficiency Minimum of five (5) years' experience in the practice of Cardiology is preferred Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an “excluded person” by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare. No history of a major disciplinary or legal action by a state medical board To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration. 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 ********************** for further assistance. The expected base salary/wage range for this position is $120-$140/hr. 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.
    $120-140 hourly Auto-Apply 13d ago
  • Senior Quality Specialist (Accreditation)

    Evolent 4.6company rating

    Evolent job in Columbus, OH

    **Your Future Evolves Here** 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:** **Put your passion where it meets purpose! Evolent attracts some of the brightest minds in health care. Surround yourself with talented, driven colleagues who share a passion for better health outcomes and a more connected care journey. We are hiring for a Senior Quality Specialist (Accreditation) to join our Quality Team.** Join the Evolent Quality Department where we embrace new ideas, drive for compliance for accreditation success and challenge ourselves to deliver to meet all business needs in a collaborative, positive culture. We respect and celebrate individual talents, and team wins while working to achieve a constant state of accreditation survey readiness. This position supports the accreditation and quality functions for Evolent Health. **Collaboration Opportunities:** The Senior Quality Specialist for Accreditation role will work closely with the NCQA Manager in collaboration with multiple departments in meeting the accreditation document requirements. This role will work autonomously in ensuring compliance with accreditation requirements with ongoing education to leadership, staff and physician group. **What You Will Be Doing:** Serves as a member of the quality team. Supports the maintenance of a strong quality program and adherence to State, Federal, CMS, Accreditation (NCQA and/or URAC), and contractual requirements. Adherence to the organization's ability to be in a constant state of audit readiness. - Assists in the preparation of customer and external audits - Assists/leads with annotations and bookmarks for customer audits (i.e. policies and procedures, meeting minutes, other required materials/documents) - Assists/leads with gathering documents for accreditation audits - Assist leadership with finalizing documents for submission for accreditation - Facilitate meetings with internal stakeholders as needed - Assist with projects for gap analysis, compliance risk with accreditation standards - Assist with reviewing released accreditation standards, education as applicable - Assist with project management of documents, timelines for preparation of audits - Work collaboratively with quality team and leadership for delegation vendor oversight - Assist with review of vendor/delegate contracts and participates in pre-delegation - Assist with vendor/delegate annual oversight for accreditation requirements (P&Ps/document review) - Assists with policies and procedure review for accreditation requirements - Responsible in assisting with providing the data for the Monthly Operations Report (MOR) as applicable - Knowledgeable and/or SME in accreditation requirements - Any other duties as assigned by Manager or Quality leadership **Qualifications - Required and Preferred:** + Work Experience 4+ years required in Quality or healthcare related field + Education High School Diploma or college degree or higher-level education (tech/certification) + Able to work independently + Expertise in data management, data analysis, reports, and project management skills + Strong working knowledge of Microsoft products and systems + Excellent verbal and written skills and the ability to enter data accurately into spread sheets and prepare professional looking documents and reports + Preferred Lean Six Sigma Certified or similar Quality certification To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration. **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** ************************** **for further assistance.** The expected base salary/wage range for this position is $78,000. 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. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!
    $78k yearly 12d ago
  • Call Center Coordinator

    Community Care of North Carolina Inc. 4.0company rating

    Remote or Garner, NC job

    The Call Center Coordinator is responsible for telephonic outreach and screening of identified members based on plan stratification for care management with a call center approach. Call Center staff also monitor for incoming calls, process referrals, and assist with any questions or needs identified. An experienced and energetic communicator, the coordinator is focused on deepening program participation as well as making members aware of CCNC (plan) programs and offerings. The Call Center Coordinator interacts with members, providers, and other staff to initiate program interventions, document activities, and refer risk appropriate members to professional staff according to protocols. The candidate for this position must have a disposition towards good customer service, be assertive without being aggressive, and always maintain a professional demeanor. The Call Center Coordinator will work remotely to cover the needs across the state. This is primarily a remote position. Occasional in-person training and travel may be required. Essential Functions Conduct continual telephonic outreach to identified and referred members focused on engaging members with care management services. Receive/retrieve and manage referrals from callers and/or data reports, linking members with care management needs as identified. Complete and document member screenings tools and refer clinical needs to most appropriate clinical care management team member for assessment and follow up Verify demographic information. Send educational materials, Welcome Letters, and/or other resources to members, as necessary. Assist to identify and address Social Determinant of Health needs. Assist with guidance in scheduling medical appointments and transportation as needed. Provide information on community resources. Assist member with care coordination of resource needs and health care system navigation. Provide culturally appropriate general education and information. Meet monthly productivity and role expectations. Complete all assignments within expected timeframes. Perform other duties that assist in keeping the operations organized and functions as needed Notify supervisor promptly of any issues with receiving or sending referrals, making timely care management assignments, or issues with carrying out any other duties assigned Collaborate with the Care Team to address barriers and create efficiencies with processes Abide by department guidelines, company policies, and HIPAA regulations Perform all other duties as requested. Attend departmental and corporate meetings. Understand and uphold CCNC goals, objectives, and standards. Qualifications High School/GED. Prior telephonic call center experience desired. Minimum of two years previous work experience, preferably in a health care setting. Healthcare experience and medical terminology knowledge highly preferred. Bilingual preferred Managed care experience a plus Knowledge, Skills, and Abilities Computer skills required including various office software and the internet; experience with MS Office software preferred. Strong Initiative and Attention to detail. Performance metric driven and productivity mindset. Strong oral and written communication proficiency Organizational and Time Management Skills Strong Interpersonal and Critical Thinking Skills; Team-oriented Resourceful - Able to shift strategy or approach in response to the demands of a situation. Adaptable - Responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives. Motivational Interviewing Skills Knowledge of Care Management Principles Ability to work independently, multi-task, and to use sound judgment when needed. Outgoing and energetic attitude; Respectful customer service skills Ability to provide information in a manner that is culturally and linguistically appropriate Knowledge of and experience working in member or clinical data systems Working Conditions The job environment is a home environment. Routinely there may be some minor physical inconveniences or discomforts in the work setting, including sitting for moderate periods of time and repetitive wrist motion. The job environment can be intense as high volume, repetitive work is an expectation
    $30k-39k yearly est. Auto-Apply 24d ago
  • VP, Client Value

    Evolent 4.6company rating

    Evolent job in Columbus, OH

    **Your Future Evolves Here** 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:** **About Evolent** Evolent Health partners with health plans and providers to drive clinical and financial performance, improve health outcomes, and deliver value-based care solutions. We are committed to transforming healthcare for the better. **Role Overview** The **Vice President, Client Value** will serve as a strategic leader responsible for effective management of value-based contracts in the Performance Suite. The VP will have specific accountability for overall financial and medical expense performance for a segment of Evolent's Performance Suite portfolio. The VP will track and monitor overall financial performance, underlying trends in cost and utilization, and operational and programmatic metrics. The VP will leverage these data, internal and external client input, and overall Evolent enterprise strategic insights to develop client-specific performance plans. Performance plan implementation will rely on a cross-functional team of leaders across clinical, product, finance, strategy, and more. The VP will lead this cross-functional team to both effectively scale core Evolent programs across clients, as well as develop new client and market-specific programs designed to drive improved outcomes. Example programs and initiatives that may fall within a client specific performance plan may include: partnering with practices to improve in-clinic workflows, design of population-wide clinical programs that drive improved cost and quality outcomes, establishment of incentive programs and payment models that align provider economics with Evolent objectives, and more. The role requires a leader with a dynamic skill set: the VP must be an adept operator who is able to drive smooth program implementations and monitor and respond to operational challenges; the VP must also be able to formulate a strategic vision, and translate that vision into an actionable roadmap for the rest of the Client Value and Performance Suite teams. Finance and Performance functions in the Performance Suite, Strategic Accounts, and Clinical Operations will be key partners for the Client Value team. The VP, Client Value will oversee a team of strategic and operational leaders with market and project-specific responsibilities. Market-embedded resources that interface directly with provider practices and client teams will report in and be part of the overall Client Value team. **Key Responsibilities** + **Client Value Strategy:** Develop and execute strategies to maximize client value and satisfaction across Evolent's portfolio. Maintain client-specific MER performance plans that represent performance on Evolent's core condition management solutions, as well as local / market-specific solutions that together ensure each Performance Suite client achieves its performance targets. + **Performance Oversight:** Monitor and report on client performance metrics, proactively identifying opportunities for improvement. Partner closely with EVH finance and analytics teams to design effective and actional reporting that both enable effective internal business management, as well as enable client-facing reporting that clearly demonstrates Evolent's value creation. + **Operational Excellence** : Collaborate with implementation and operations teams to ensure successful product deployment and adoption; monitor product performance and provider satisfaction metrics to drive continuous improvement + **Cross-Functional Leadership:** Collaborate with internal teams (clinical, operations, analytics, and product) to deliver integrated solutions. Partner with Performance Suite and Solution Strategy teams to identify clients and market where new programs and innovations can be piloted. + **Collaboration:** Optimize partnership with rest of Client Value team, ensure appropriate division of work, ensure appropriate collaboration and communication. + **Executive Communication:** Present value outcomes and strategic recommendations to client executives and Evolent leadership. + **Team management:** Oversee a team of market-specific professionals; ensure highest priority initiatives are appropriately staffed and resourced; provide direction, support, and mentorship to support performance and development of the Client Value team. + **Team Culture:** Steward a culture of integrity, inclusion, accountability, and teamwork within the Client Value team and with Performance Suite and Evolent more broadly. **Qualifications** + **Experience:** 10+ years in healthcare, consulting, or client management roles, with a proven track record of delivering measurable value. + **Leadership:** Strong executive presence and ability to influence at all organizational levels. + **Analytical Skills:** Expertise in interpreting complex data and translating insights into actionable strategies. + **Industry Knowledge:** Deep understanding of value-based care, health plan operations, and provider partnerships. + **Education:** Bachelor's degree required; advanced degree preferred. To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration. **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** ************************** **for further assistance.** The expected base salary/wage range for this position is $-. 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. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!
    $108k-159k yearly est. 12d ago
  • Communications Specialist (Entry-Level)

    Altarum 4.5company rating

    Remote job

    We're excited to share an upcoming opportunity (pending a contract award) and are building a pipeline of qualified candidates in advance. Hiring is expected to begin once the final award is confirmed, anticipated within the next 2-3 months. As a Communications Specialist (Account Executive), you'll contribute to projects across the research and execution phases, help design solutions, and make meaningful contributions to your team. You'll manage up and across teams, support client relationships, produce drafts of work, reports, and analyses, monitor changes in the environment that may affect client success, and ensure the quality and timeliness of client deliverables. In this role, you'll be part of Palladian Partners, Altarum Enterprise's full-service marketing and communications team, where you'll work collaboratively to deliver innovative, high-impact solutions for our clients.What You'll Do Participate in planning, research, writing, and strategy development Draft high-quality correspondence, communication materials, reports, and other types of materials for internal audiences and clients Communicate directly with clients and external partners to implement strategies and tactics Draft project plans and track project activities, timelines, and quality reviews Support social, paid, and traditional media outreach, including strategy, content development, and analytics Support content creation by communicating ideas and working with integrated project teams of designers, writers, and digital strategists to develop creative and digital assets, including videos, websites, infographics, and more Provide client service support with regular monitoring and reporting, managing timelines, proofreading, and client touchpoints Collaborate with other team members to address challenges and solve problems proactively Attend and contribute to meetings, including taking actionable notes in both internal and external meetings, handle scheduling and logistics Participate in new business process including research and proposal preparation Contribute to organic growth What You'll Bring Strong written and verbal communication skills Excellent interpersonal and multidisciplinary project skills Ability to work collaboratively on a team and with key stakeholders and clients Action-oriented, organized, proactive, and adaptable approach to project coordination Proven ability to meet deadlines and work on multiple projects simultaneously Demonstrated attention to detail and commitment to customer service Education and Experience Bachelor's degree with 1-2 years of work experience Master's degree or PHD a plus Government contracting and/or agency experience preferred Where You'll Work Remote with occasional in-person collaboration days If you're near one of our offices (Arlington, VA; Silver Spring, MD; or Novi, MI), you'll join us in person one day every other month (6 times per year) for a fun, purpose-driven Collaboration Day. These days are filled with creative energy, meaningful connection, and team brainstorming! Non-local employees may be asked to join us on these days at an approved co-working space. Work Eligibility & Requirements Candidates must be currently eligible to work in the United States; sponsorship is not available. All work must be performed within the continental U.S. for the duration of employment, unless required by contract. Ability to work core hours aligned with Eastern Time, unless otherwise approved by your manager. Remote employees must maintain a dedicated, ergonomically appropriate workspace free from distractions, with reliable internet and a mobile device that supports efficient work. Federal Clearance & Badge Because this role supports federal clients, you'll need to complete a federal background investigation to determine your suitability for federal employment. You may also be required to obtain an HHS Personal Identity Verification (PIV) Badge in addition to Palladian's standard background process. Learn more about the federal suitability and PIV process here: ******************************************************************************************************************************** Altarum is a nonprofit organization focused on improving the health of individuals with fewer financial resources and populations disenfranchised by the health care system. We work primarily on behalf of federal and state governments to design and implement solutions that achieve measurable results. We combine our expertise in public health and health care delivery with technology development and implementation, practice transformation, training and technical assistance, quality improvement, data analytics, and applied research and evaluation. Our innovative solutions and proven processes lead to better value and health for all. Altarum is an equal opportunity employer that provides employment and opportunities to all qualified employees and applicants without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, or any other characteristic protected by applicable law.
    $43k-59k yearly est. Auto-Apply 19d ago
  • Analyst, Application Support

    Evolent 4.6company rating

    Evolent job in Columbus, OH

    **Your Future Evolves Here** 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:** The **Analyst, Application Support** is a highly motivated person with excellent communication and interpersonal skills to interact with internal/external teams and application users and help trouble shoot/resolve issues reported by various departments within Evolent. This person will provide high quality operational, technical, and systems support to preserve customer satisfaction and internal business functions to aid in minimizing recurrence of incidents. What You'll Be Doing: + Provide first-level support, including problem replication, triage, and resolution of issues, the majority of which are associated with Standard Operating Procedures (SOPs) + Provide accurate and timely resolution of issues, and escalation when necessary + Ensure that Service Level Agreements (SLAs) are met + Maintain and update documentation related to operations and support processes within Confluence + Contributes to improvement of existing processes and identification of new processes and technical alternatives to resolve problems + Collaborate with team members and business functions to troubleshoot and resolve support tickets + Respond to escalations and incidents, providing support toward resolution, and notifying stakeholders of progress during business hours and outside of normal business hours (on-call support) + Contribute to writing T-SQL code and tools to assist Level 1 support to diagnose and resolve incidents + Execute SQL scripts to generate reports, troubleshoot data issues, and fulfill database support tasks + Perform ad-hoc task and analysis for the support team as needed + Perform quarterly user access audit The Experience You'll Need (Required): **Experience:** + Bachelor's degree in Computer Science, IT- related degree or comparable experience + 1+ year(s) of progressive experience within application support/IT operations organizations + 1+ year(s) experience with T-SQL, ability to view and write T-SQL code for triage and investigation + Professional verbal and written communication skills, with the ability to clearly articulate thoughts and ideas. + Basic knowledge of web application functionality and fundamental Infrastructure knowledge of computer systems. + Collaborative working style with the ability to work across different organizations and personalities + Ability to work unsupervised and a self-starter who seeks improvements without direction Finishing Touches (Preferred): + Experience in a healthcare-related field + Familiarity with JIRA, Confluence, Microsoft Azure - Application Insights + JIRA Service Desk ticketing system/Confluence experience To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration. **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** ************************** **for further assistance.** The expected base salary/wage range for this position is $. 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. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!
    $69k-99k yearly est. 25d ago
  • Clinical Reviewer, Nurse (Medical Oncology)

    Evolent 4.6company rating

    Evolent job in Columbus, OH

    **Your Future Evolves Here** 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:** **Your Future Evolves Here** 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:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed within the **RN/LVN/LPN** scope of practice, under the Medical Director's direction, using independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum and working in concert with the health care delivery team to maintain high-quality, cost-effective care delivery. + Perform pre-certification utilization reviews of **Oncology treatment requests** + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review rationales and determinations. + Appropriately identifies and refers cases that do not meet established clinical criteria to the Medical Director. + Appropriately identifies and refers quality issues to UM Leadership. + Collaborates with physicians and other providers to facilitate the provision of services throughout the health care continuum. + Performs accurate data entry. + Communicates appropriate information to other staff members as necessary/required. + Participates in continuing education initiatives. + Availability on some weekends and holidays may be required. + Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, unrestricted license. + High School Diploma or equivalent required + Minimum of three years of direct clinical patient care (acute, inpatient, or critical care setting); strongly prefer direct Oncology experience. + Strong computer skills, including MS Office Suite + Strong interpersonal, oral, and written communication skills. + Availability for weekend holiday rotation. **Finishing Touches (Preferred):** + Experience with clinical decision-making criteria sets (i.e., Milliman, InterQual) + Minimum of one year of experience with medical management activities in a managed care environment + UM/UR experience + Clinical experience in Oncology, ICU, ED, or other critical care environment + Remote work experience To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration. **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** ************************** **for further assistance.** The expected base salary/wage range for this position is $32-$37 /hr. 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. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!
    $32-37 hourly 20d ago
  • Managing Director, Actuarial Services

    Evolent 4.6company rating

    Evolent job in Columbus, OH

    **Your Future Evolves Here** 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:** **Job Description** Put your passion where it meets purpose! Evolent attracts some of the brightest minds in health care. Surround yourself with talented, driven colleagues who share a passion for better health outcomes and a more connected care journey. We are hiring for a Managing Director, Actuarial Services to join our Finance Team. The candidate selected for this role will be part of a team who thrives on driving analysis and support for Evolent's fast growth and innovative risk-based Performance Suite business. **Collaboration Opportunities:** This person will work cross-functionally with many departments across the organization to analyze, communicate, and negotiate client performance and contracting. **What You'll Be Doing:** + Serve as the lead for medical cost and revenue projections for Performance Suite business + Partner with Performance Solutions to analyze and size impact of innovative care models + Oversee Medical Cost Action Planning work to identify, size, and support new programs aimed at reducing cost of care + Partner with Performance Suite Analytics leaders to understand cost drivers to inform future cost expectations + Coordinate with internal teams to ensure clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for communication to key internal and external executive stakeholders + Partner with team members across the organization to ensure accurate and timely delivery of quarterly forecast updates + Build tools and capabilities to quantify and narrow range of expected outcomes for financial performance + Participate in execution of complex deal structures for potential new and existing clients + Perform ad hoc client-specific analyses to support strategic decision-making **Qualifications - Required and Preferred:** + Bachelor's degree in quantitative field **(Required)** + Associate of Society of Actuaries credentials **(Required)** + 10+ years of experience working in a medical economics-related field **(Required)** + Exceptionally strong analytical abilities, with a track record of identifying insights from financial information and translating into recommendations **(Required)** + Ability to multitask, prioritize, adapt to change, work well under pressure in an entrepreneurial environment, and manage a project from start to finish **(Required)** + Able to work independently to meet deadlines within time constraints **(Required)** + Strong interpersonal skills to coordinate with people across all areas of the organization in a fast-paced, dynamic environment **(Required)** + Strong communication skills with ability to work with technical and non-technical audiences **(Required)** + Ability to handle ambiguity and demonstrate initiative to identify and resolve problems **(Required)** + Experience delivering executive-level presentations for strategic decision-making **(Required)** + Basic knowledge of risk/capitation contracting **(Required)** + Experience with project and stakeholder management **(Required)** + Fellow of Society of Actuaries credentials with Group Health track **(Preferred)** + Familiarity with healthcare claim processing **(Preferred)** + 5+ years experience at payer or management consulting firm **(Preferred)** + Basic knowledge of GAAP **(Preferred)** To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration. **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** ************************** **for further assistance.** The expected base salary/wage range for this position is $165,000-180,000. 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. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!
    $165k-180k yearly 60d+ ago
  • Principal Data Engineer - ML Platforms

    Altarum 4.5company rating

    Remote job

    Altarum | Data & AI Center of Excellence (CoE) Altarum is building the future of data and AI infrastructure for public health - and we're looking for a Principal Data Engineer - ML Platforms to help lead the way. In this cornerstone role, you will design, build, and operationalize the modern data and ML platform capabilities that power analytics, evaluation, AI modeling, and interoperability across all Altarum divisions. If you want to architect impactful systems, enable data science at scale, and help ensure public health and Medicaid programs operate with secure, explainable, and trustworthy AI - this role is for you. What You'll Work On This role blends deep engineering with applied ML enablement: ML Platform Engineering: modern lakehouse architecture, pipelines, MLOps lifecycle Applied ML enablement: risk scoring, forecasting, Medicaid analytics NLP/Generative AI support: RAG, vectorization, health communications Causal ML operationalization: evaluation modeling workflows Responsible/Trusted AI engineering: model cards, fairness, compliance Your work ensures that Altarum's public health and Medicaid programs run on secure, scalable, reusable, and explainable data and AI infrastructure. What You'll Do Platform Architecture & Delivery Design and operate modern, cloud-agnostic lakehouse architecture using object storage, SQL/ELT engines, and dbt. Build CI/CD pipelines for data, dbt, and model delivery (GitHub Actions, GitLab, Azure DevOps). Implement MLOps systems: MLflow (or equivalent), feature stores, model registry, drift detection, automated testing. Engineer solutions in AWS and AWS GovCloud today, with portability to Azure Gov or GCP. Use Infrastructure-as-Code (Terraform, CloudFormation, Bicep) to automate secure deployments. Pipelines & Interoperability Build scalable ingestion and normalization pipelines for healthcare and public health datasets, including: FHIR R4 / US Core (strongly preferred) HL7 v2 (strongly preferred) Medicaid/Medicare claims & encounters (strongly preferred) SDOH & geospatial data (preferred) Survey, mixed-methods, and qualitative data Create reusable connectors, dbt packages, and data contracts for cross-division use. Publish clean, conformed, metrics-ready tables for Analytics Engineering and BI teams. Support Population Health in turning evaluation and statistical models into pipelines. Data Quality, Reliability & Cost Management Define SLOs and alerting; instrument lineage & metadata; ensure ≥95% of data tests pass. Perform performance and cost tuning (partitioning, storage tiers, autoscaling) with guardrails and dashboards. Applied ML Enablement Build production-grade pipelines for risk prediction, forecasting, cost/utilization models, and burden estimation. Develop ML-ready feature engineering workflows and support time-series/outbreak detection models. Integrate ML assets into standardized deployment workflows. Generative AI Enablement Build ingestion and vectorization pipelines for surveys, interviews, and unstructured text. Support RAG systems for synthesis, evaluation, and public health guidance. Enable Palladian Partners with secure, controlled-generation environments. Causal ML & Evaluation Engineering Translate R/Stata/SAS evaluation code into reusable pipelines. Build templates for causal inference workflows (DID, AIPW, CEM, synthetic controls). Support operationalization of ARA's applied research methods at scale. Responsible AI, Security & Compliance Implement Model Card Protocol (MCP) and fairness/explainability tooling (SHAP, LIME). Ensure compliance with HIPAA, 42 CFR Part 2, IRB/DUA constraints, and NIST AI RMF standards. Enforce privacy-by-design: tokenization, encryption, least-privilege IAM, and VPC isolation. Reuse, Shared-Services, and Enablement Develop runbooks, architecture diagrams, repo templates, and accelerator code. Pair with data scientists, analysts, and SMEs to build organizational capability. Provide technical guidance for proposals and client engagements. Your First 90 Days - You will make a meaningful impact fast. Expected outcomes include: Platform skeleton operational: repo templates, CI/CD, dbt project, MLflow registry, tests. Two pipelines in production (e.g., FHIR → analytics and claims normalization). One end-to-end CoE lighthouse MVP delivered (ingestion → model → metrics → BI). Completed playbooks for GovCloud deployment, identity/secrets, rollback, and cost control. Success Metrics (KPIs) Pipeline reliability meeting SLA/SLO targets. ≥95% data tests passing across pipelines. MVP dataset onboarding ≤ 4 weeks. Reuse of platform assets across ≥3 divisions. Cost optimization and budget adherence. What You'll Bring 7-10+ years in data engineering, ML platform engineering, or cloud data architecture. Expert in Python, SQL, dbt, and orchestration tools (Airflow, Glue, Step Functions). Deep experience with AWS + AWS GovCloud. CI/CD and IaC experience (Terraform, CloudFormation). Familiarity with MLOps tools (MLflow, Sagemaker, Azure ML, Vertex AI). Ability to operate in regulated environments (HIPAA, 42 CFR Part 2, IRB). Preferred: Experience with FHIR, HL7, Medicaid/Medicare claims, and/or SDOH datasets. Databricks, Snowflake, Redshift, Synapse. Event streaming (Kafka, Kinesis, Event Hubs). Feature store experience. Observability tooling (Grafana, Prometheus, OpenTelemetry). Experience optimizing BI datasets for Power BI. Logistical Requirements At this time, we will only accept candidates who are presently eligible to work in the United States and will not require sponsorship. Our organization requires that all work, for the duration of your employment, must be completed in the continental U.S. unless required by contract. If you're near one of our offices (Arlington, VA; Silver Spring, MD; or Novi, MI), you'll join us in person one day every other month (6 times per year) for a fun, purpose-driven Collaboration Day. These days are filled with creative energy, meaningful connection, and team brainstorming! Must be able to work during Eastern Time unless approved by your manager. Employees working remotely must have a dedicated, ergonomically appropriate workspace free from distractions with a mobile device that allows for productive and efficient conduct of business. Altarum is a nonprofit organization focused on improving the health of individuals with fewer financial resources and populations disenfranchised by the health care system. We work primarily on behalf of federal and state governments to design and implement solutions that achieve measurable results. We combine our expertise in public health and health care delivery with technology development and implementation, practice transformation, training and technical assistance, quality improvement, data analytics, and applied research and evaluation. Our innovative solutions and proven processes lead to better value and health for all. Altarum is an equal opportunity employer that provides employment and opportunities to all qualified employees and applicants without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, or any other characteristic protected by applicable law.
    $72k-98k yearly est. Auto-Apply 28d ago
  • Member Engagement Specialist

    Community Care of North Carolina Inc. 4.0company rating

    Remote or Cary, NC job

    The Member Engagement Specialist is responsible for telephonic outreach and screening of identified members based on plan stratification for care management with a call center approach. An experienced and energetic communicator, the engagement specialist is focused on deepening program participation as well as making members aware of CCNC (Community Care of North Carolina) (plan) programs and offerings. The Member Engagement Specialist interacts with members, providers, and other staff to initiate program interventions, document activities, and refer risk appropriate members to professional staff according to protocols. The candidate for this position must have a disposition towards good customer service, be assertive without being aggressive, and always maintain a professional demeanor. The Member Engagement Specialist may work remotely within regions to cover the needs across the state. This is primarily a remote position. Occasional in-person training and travel may be required. Essential Functions Conduct continual telephonic outreach to identified and referred members focused on engaging members with care management services. Receive/retrieve and manage referrals from data reports; clinical care management team members, PCP (Primary Care Provider), or other service providers for efficient screening and linking members with care management. Complete and document member screenings tools and refer clinical needs to most appropriate clinical care management team member for assessment and follow up. Schedule members for face-to-face or telephonic encounters for care management follow up. Meet monthly productivity and role expectations. Complete all assignments within expected timeframes. Notify supervisor promptly of any issues with receiving or sending referrals, making timely care management assignments, or issues with carrying out any other duties assigned. Collaborate with the Care Team to address barriers and create efficiency with processes. Abide by department guidelines, company policies, and HIPAA regulations. Perform all other duties as requested. Attend departmental and corporate meetings. Understand and uphold CCNC goals, objectives, and standards. Qualifications High School/GED. Prior telephonic call center experience desired Minimum of two years previous work experience, preferably in a health care setting Healthcare experience and medical terminology knowledge highly preferred Bilingual preferred Managed care experience a plus Knowledge, Skills, and Abilities Computer skills required including various office software and the internet; experience with MS Office software preferred Strong Initiative Performance metric driven and productivity mindset Strong oral and written communication proficiency Attention to detail Organizational and Time Management Skills Strong Interpersonal Skills Critical Thinking Skills Resourceful - Able to shift strategy or approach in response to the demands of a situation Team-oriented Adaptable - Responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives Motivational Interviewing Skills Knowledge of Care Management Principles Ability to work independently and to use sound judgment when needed Multi-tasking Abilities Outgoing and energetic attitude Respectful customer service skills Ability to provide information in a manner that is culturally and linguistically appropriate Knowledge of and experience working in member or clinical data systems Working Conditions Routinely there may be some minor physical inconveniences or discomforts in the work setting, including sitting for moderate periods of time and repetitive wrist motion Must be able to utilize office equipment, computer, keyboard, and phone with or without assistive devices Repetitive wrist motion and occasional lifting/carrying of up to 25 pounds The job environment is a home environment Travel using personal vehicle may be required within the region and/or the State The job environment can be intense as high volume, repetitive work is an expectation
    $30k-38k yearly est. Auto-Apply 40d ago

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Evolent Health may also be known as or be related to EVOLENT HEALTH INC., Evolent Health, Evolent Health Inc and Evolent Health, Inc.