Evolent Health jobs in Washington, DC - 64 jobs

**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:** **Director, Strategic Accounts** **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 a **Director, Strategic Accounts** to join our Customer Team. This role is unique: you will work directly with one of Evolent's largest, growing health plan clients and lead account strategy and execution. You'll have direct oversight of sales pipeline and renewals. This position partners with a customer operations lead and as a dyad you'll oversee cross-functional business and operating teams managing key client priorities. This position is highly strategic, with a strong emphasis on **upsell/cross-sell opportunities by fostering relationships, solutioning and problem solving, and communicating value.** **Collaboration Opportunities** As a consultative leader, you will identify growth opportunities within health plan specialty management and Evolent. The Strategic Account Director will implement relationship best practices, deliver on strategic growth initiatives, and drive measurable value while increasing satisfaction across all levels of the partner organization. **What You'll Be Doing** + **Strategically manage** an assigned book of business to achieve objectives in relationship development, growth, retention, and customer success. + **Identify and pursue growth opportunities** through analysis, customer research and active listening. Manage deal cycle including pitch, scope development, pricing, contract negotiations and implementation readiness. + **Define and facilitate execution of multi-year account strategy** including strategic account planning, relationship mapping, competitive analysis, and issue resolution. + **Manage and optimize contracts and performance** , by effectively partnering with Customer Operations dyad partner and Business Line leaders-ensuring compliance with SLAs, maximizing savings through benefit analysis, and adhering to legal and regulatory requirements. + **Articulate Evolent's value proposition and performance** across products and services, establishing fluency in key value drivers and measurements and opportunities for improvement + **Cultivate trusted relationships** with key executives, including C-level stakeholders, and serve as a liaison between internal and external teams. + **Leverage data-driven insights** to run efficient meetings and work sessions with clients and subject matter experts. + **Develop best-in-class presentations** and narratives for senior stakeholder meetings. + **Serve as an ambassador** for partner culture within Evolent and act as the go-to expert on client priorities. **Preferred Experience** + Bachelor's degree or equivalent work experience. + 5+ years of broad-based health care experience, health plan, and/or specialty or value-based care experience preferred + Strong **consulting background** with expertise in strategy, business development, and value based arrangements. + Ability to find creative solutions in a dynamic, evolving environment. + Exceptional communication and influencing skills at all organizational levels, including C-suite. + High emotional intelligence and ability to connect with diverse stakeholders. + **Travel:** Up to 40% within the U.S. and U.S. territories. 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!

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.

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.

**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:** As an Occupational Therapist, Clinical Reviewer you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical environment. You can enjoy better work- life balance on a team that values collaboration and continuous learning while providing better health outcomes. Collaboration Opportunities: + Routinely interacts with leadership and management staff, Physicians, and and other CR's whenever input is needed or required. Job Summary Functions in a clinical review capacity to evaluate all cases, which do not pass the authorization approval process at first call while promoting a supportive team approach with call center staff. Initial clinical reviewers are supported by Physician clinical review staff (MDs) in the utilization management determination process. Job Description + Reviews charts and analyzes clinical record documentation in order to approve services that meet clinical review criteria. + Conducts ongoing activities which monitor established quality of care standards in the participating provider network and for other clinical staff. + Conducts regular audits, as assigned, to ensure guidelines are applied appropriately. + In states where required, refers all cases that an approval cannot be rendered to the Physician Clinical Reviewer. In States where allowed, will make denial determinations as a specific case warrants. + Converses with medical office staff in order to obtain additional pertinent clinical history/information; notifies of approvals and denials, giving clinical rationale. + Provides optimum customer service through professional/accurate communication while maintaining NCQA and health plans required timeframes. + Documents all communication with medical office staff and/or treating provider. + Practices and maintains the principles of utilization management by adhering to policies and procedures. + Participates in on-going training programs to ensure quality performance in compliance with applicable standards and regulations. **The Experience You'll Need (Required):** + Current, unrestricted state licensure as a Occupational Therapist + A occupational therapist must hold a state license in occupational therapy and hold an occupational therapy degree from an accredited education program and pass the national certification examination. + 5+ years clinical experience is preferred + Strong interpersonal and communication skills. + Strong clinical, communication, and organizational skills + Energetic and curious with a passion for quality and value in health care + Computer Proficiency + 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 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 $. 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!

**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 Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Vascular Surgey is responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices of the office of the Chief Medical Officer. ESSENTIAL DUTIES AND RESPONSIBILITIES: include the following. Other duties may be assigned. + Responsible for acting as a clinical liaison to providers, clients, and patients as directed by the office of the Chief Medical Officer. + Responsible for clinical conversations with providers and their office staff regarding medical necessity decisions. + Responsible for maintaining and operating the Guideline Directed Medial Therapy including communicating with offices recommendations regarding medical therapy. + Responsible for communicating need for additional clinical information to ordering providers. + Responsibility for prepping cases which cannot be approved and which the provider will not modify or withdraw for P2P discussions with one of the Vascular Surgeons or Cardiologists. + Responsible for coordinating with UM staff to ensure timely and accurate communication of clinical decisions. + Responsible for completion of UM projects and participation in site visit reviews. + Respect and maintain HIPAA confidentiality guidelines. + Responsible for maintaining availability to clinical and non-clinical administrative staff during performance of initial and second level screening + Acts as an interdepartmental liaison between all New Century Health offices, departments, and committees. + Serve as subject matter expert and participate in meetings as assigned with practices and/or payers. + Will work with the Director of UM to ensure client satisfaction. + Perform all peer clinical review activities while located in a state or territory of the United States. + Acts with honor and integrity, serving as a role model for the company. + Performs other duties as assigned. QUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. EDUCATION and/or EXPERIENCE: Master of Science in Nursing or Doctor of Nursing Practice (DNP) degree from a recognized degree program OR a master's degree from a program accredited the ARC-PA. Minimum of five (5) years' experience in the practice of Vacular Surgery (preferred) or primary care; knowledge of regulatory requirements with at least two years of experience in a regulatory role (preferred). LICENSE/CERTIFICATION: Current, unrestricted state PA or RN/NP license in medicine or required specialty. Of a PA, obtaining a passing score on a national certifying exam Obtaining and maintaining required licenses in the states where NCH has business OTHER SKILLS and ABILITIES: Strong clinical, management, communication, and organizational skills. Demonstrated leadership skills Analytic skills Energetic and curious with a passion for quality and value in health care Required to pass skills proficiency test 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 $68-$74/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!

**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 Will 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 **Qualifications - Required:** + 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 + **This role is Monday- Friday from 9:00 am to 6:00pm, CST, MST or PST. with some flexibility. Additionally rotating on-call support, including after-hours, weekends and holidays.** **Qualifications - 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 $28.00 to $31.00. 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!

**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!

**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:** **Director, Client Value** **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 **Director, Client Value** will serve as a key member of the Client Value team, responsible for the effective management of value-based contracts in the Performance Suite. Under the direction of the VP, Client Value, the Director will have specific accountability for overall financial and medical expense performance for a segment of Evolent's Performance Suite portfolio. The Client Value team will track and monitor overall financial performance, underlying trends in cost and utilization, and operational and programmatic metrics. The Client Value team will leverage these data, internal and external client input, and overall Evolent enterprise strategic insights to develop client-specific performance plans. The Director will play a role in coordinating projects and programs that are identified as the highest value / highest priority topics for delivering cost and quality results. The Director will call together and facilitate cross-functional teams across clinical, product, finance, strategy, and more. 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 Director will have a variety of duties that may include: interfacing directly with clients to surface opportunities and co-design improvement projects, overseeing operational implementation of new pilots and programs, tracking performance on core UM and provider engagement metrics, and translating Client Value business plans into materials and messages appropriate for externally-facing client communications. Finance and Performance functions in the Performance Suite, Strategic Accounts, and Clinical Operations will be key partners for the Client Value team. 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:** Participate in the development of strategies to maximize client value and satisfaction across Evolent's portfolio. Support 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. Regularly monitor and utilize all available financial and analytic reporting. Assist in the development of client-facing communications related to Evolent performance. + **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:** 5-8+ 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 $120,000-130,000. 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!

**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:** Responsibilities + Design, develop, test, and maintain software applications using modern programming languagesand frameworks. + Collaborate with product managers, designers, and other engineers to translate requirementsinto technical specifications. + Write clean, maintainable, and efficient code, following best practices and coding standards. + Participate in code reviews to ensure code quality, functionality, and maintainability. + Troubleshoot, debug, and resolve technical issues and bugs in a timely manner. + Optimize applications for maximum performance, scalability, and reliability. + Contribute to the continuous improvement of development processes, tools, and + methodologies. + Stay up-to-date with emerging technologies and industry trends, and apply them to improve ourproducts and solutions. Requirements + Bachelor's degree in Computer Science, Software Engineering, or a related field, or equivalent + practical experience. + Proven experience in software development using languages such as C#, Java, Python, JavaScript,etc. + Strong understanding of software design principles, algorithms, and data structures. + Experience with front-end frameworks (e.g., React, Angular, Vue) and/or back-end technologies(e.g., Node.js, Django, Spring). + Familiarity with version control systems such as Git and collaborative coding workflows. + Experience with cloud platforms (e.g., Azure, AWS, Google Cloud) and containerization tools + (e.g., Docker, Kubernetes). + Ability to write unit, integration, and end-to-end tests to ensure code quality and reliability. + Excellent problem-solving skills and the ability to work independently and as part of a team. + Strong communication skills with the ability to articulate technical concepts to both technicaland non-technical stakeholders. 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 $73,200 - 102,500. 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!

**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:** Our Performance Suite Analytics team offers candidates the opportunity to support the evolution of value-based care across all lines of business by collaborating directly with our health plan partners. We are advocates for creating patient value and demonstrate this by ensuring that our risk-based financial arrangements are equitable and sustainable. We are pioneers in supporting the development of new innovative patient solutions through modeling and insights empowered by data. **Collaboration Opportunities:** This individual will serve as a leader in Performance Suite Analytics team at Evolent. This role is primarily focused on leading a team supporting analytics for evaluating financial/quality performance and complex financial reconciliations with our risk-based partnerships. This individual will partner closely with executives across finance, program innovation, and account management. **What You Will Be Doing:** + Key leader of the analytics partnership with Client & Product teams to outline strategic approach for current risk partnerships, various value-based care models, financial/quality based metrics, and provide discovery and product design analytical support. + Serving as strategic owner of our analytics capabilities and processes related to evaluating performance with our capitated risk partnerships including cost & use projections, financial reconciliations, and providing insight in utilization drivers. + Analyze performance capitated risk partnerships, focusing on cost and use trends, and estimate Evolent's ability to reduce costs and improve quality. + Assisting in the development of budgets and forecasts for each client and packaging key insights for tracking performance. + undefined + Leading and facilitating interactions with existing customers in a manner that fosters trust in Evolent's expertise and a spirit of collaboration. + Collaborating with internal/external business customers to understand their problems and objectives, solve business questions, and help them to achieve goals by performing statistical analysis, developing analytic models, creating data reports/dashboards using a variety of performance metrics. + Partnering with other analytical, product and IT leaders in assessing new and existing analytical tools and continuously improving analytical processes. + Managing, mentoring, and coaching members of the team. + undefined + Setting clear goals and objectives using metrics to measure performance while holding staff accountable. + Develop models to quantify and articulate value. + Communicate actionable conclusions from analyses to executive internal/external audiences. + Extract, manage, and analyze claims and operational data using industry-standard metrics. **The Experience You'll Need (Required):** · Bachelor's degree, preferably with a quantitative major (e.g. actuarial, statistics, operations research, mathematics, economics) or healthcare focus (health administration, epidemiology, public health, biology) · At least 5 years of professional experience in claims-based healthcare analytics with a payer, provider, vendor, managed care, or related healthcare consulting entity · Extensive knowledge of healthcare claims; specifically, differences between institutional vs professional billing and various sites of care/service · Previous Experience with healthcare reimbursement methodologies and calculations such as Fee for Service, value based care approaches, bundled payments, etc. · Advanced or higher proficiency in Microsoft Excel · Advanced or higher proficiency in SQL or SAS database/statistical programming languages · Moderate Proficiency in Microsoft PowerPoint · Knowledge of health insurance financial business cycle, healthcare quality reporting, and benchmarking · Ability to communicate clearly with diverse stakeholders to solve problems; ability to translate between business needs and analytical needs · Exceptionally strong analytical abilities, with track record of identifying insights from quantitative and qualitative data · Prior people management experience · Ability to work independently with limited oversight 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 $130,000. 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!

**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 **Director, Service Excellence** Evolent is looking to hire a Director of Service Excellence. This individual will serve on a central team within the customer organization focused on ensuring that we deliver best-in-class service to our customers. The director will be a key connection point into cross-functional teams, representing the customer team on key issues and initiatives representing multiple partners. **Who You'll Be Working With:** The person in this role will be responsible for managing incident response, ensuring that we are addressing issues in a timely manner, monitoring outbound documents to facilitate clear and consistent messaging around our value and performance, leveraging internal SME's to educate customer-facing teams on key initiatives that drive value, and ensuring that we are providing transparent and proactive communication to our customers. **What You'll Be Doing:** + Manage voice of customer insight gathering through survey administration and customer specific primary research + Facilitate internal forums to promote alignment and accountability across internal teams (e.g., SLA timelines, product performance and value, data monitoring / platform issues, etc.) + Serve as the main customer point of contact for key initiatives with a focus on solutioning, streamlining processes and working cross-functionally to ensure timely execution + Coordinate customer communication (payer and provider) on key initiatives, projects, or issues/incidents that impact service delivery + Develop an "issue resolution" playbook, promoting consistent definitions of problem types and standardizing solutioning + Ensure SLA's are maintained via a central database, instilling best practices for monitoring and managing across the customer org + Monitor internal issue ticketing system / reporting to ensure key customer issues are being addressed in a timely manner **The Experience You'll Need (Required):** + 5+ years of experience in account management or client services role in digital health, healthcare, payer + Previous experience managing a team of direct reports + Strong track record of high client satisfaction, growth and retention + Strong verbal, written and presentation skills; ability to communicate clearly and influence internal and external stakeholders + Strong analytical skills; ability to understand data and present information accordingly + Experience working in a cross-functional capacity + Strong leadership and effective problem abilities; must be able to develop and grow relationships with executive leaders, and internal cross-functional teams 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!

**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:** As an Occupational Therapist, Clinical Reviewer you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical environment. You can enjoy better work- life balance on a team that values collaboration and continuous learning while providing better health outcomes. Collaboration Opportunities: + Routinely interacts with leadership and management staff, Physicians, and and other CR's whenever input is needed or required. Job Summary Functions in a clinical review capacity to evaluate all cases, which do not pass the authorization approval process at first call while promoting a supportive team approach with call center staff. Initial clinical reviewers are supported by Physician clinical review staff (MDs) in the utilization management determination process. Job Description + Reviews charts and analyzes clinical record documentation in order to approve services that meet clinical review criteria. + Conducts ongoing activities which monitor established quality of care standards in the participating provider network and for other clinical staff. + Conducts regular audits, as assigned, to ensure guidelines are applied appropriately. + In states where required, refers all cases that an approval cannot be rendered to the Physician Clinical Reviewer. In States where allowed, will make denial determinations as a specific case warrants. + Converses with medical office staff in order to obtain additional pertinent clinical history/information; notifies of approvals and denials, giving clinical rationale. + Provides optimum customer service through professional/accurate communication while maintaining NCQA and health plans required timeframes. + Documents all communication with medical office staff and/or treating provider. + Practices and maintains the principles of utilization management by adhering to policies and procedures. + Participates in on-going training programs to ensure quality performance in compliance with applicable standards and regulations. **The Experience You'll Need (Required):** + Current, unrestricted state licensure as a Occupational Therapist + A occupational therapist must hold a state license in occupational therapy and hold an occupational therapy degree from an accredited education program and pass the national certification examination. + 5+ years clinical experience is preferred + Strong interpersonal and communication skills. + Strong clinical, communication, and organizational skills + Energetic and curious with a passion for quality and value in health care + Computer Proficiency + 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 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 $. 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!

**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 Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Vascular Surgey is responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices of the office of the Chief Medical Officer. ESSENTIAL DUTIES AND RESPONSIBILITIES: include the following. Other duties may be assigned. + Responsible for acting as a clinical liaison to providers, clients, and patients as directed by the office of the Chief Medical Officer. + Responsible for clinical conversations with providers and their office staff regarding medical necessity decisions. + Responsible for maintaining and operating the Guideline Directed Medial Therapy including communicating with offices recommendations regarding medical therapy. + Responsible for communicating need for additional clinical information to ordering providers. + Responsibility for prepping cases which cannot be approved and which the provider will not modify or withdraw for P2P discussions with one of the Vascular Surgeons or Cardiologists. + Responsible for coordinating with UM staff to ensure timely and accurate communication of clinical decisions. + Responsible for completion of UM projects and participation in site visit reviews. + Respect and maintain HIPAA confidentiality guidelines. + Responsible for maintaining availability to clinical and non-clinical administrative staff during performance of initial and second level screening + Acts as an interdepartmental liaison between all New Century Health offices, departments, and committees. + Serve as subject matter expert and participate in meetings as assigned with practices and/or payers. + Will work with the Director of UM to ensure client satisfaction. + Perform all peer clinical review activities while located in a state or territory of the United States. + Acts with honor and integrity, serving as a role model for the company. + Performs other duties as assigned. QUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. EDUCATION and/or EXPERIENCE: Master of Science in Nursing or Doctor of Nursing Practice (DNP) degree from a recognized degree program OR a master's degree from a program accredited the ARC-PA. Minimum of five (5) years' experience in the practice of Vacular Surgery (preferred) or primary care; knowledge of regulatory requirements with at least two years of experience in a regulatory role (preferred). LICENSE/CERTIFICATION: Current, unrestricted state PA or RN/NP license in medicine or required specialty. Of a PA, obtaining a passing score on a national certifying exam Obtaining and maintaining required licenses in the states where NCH has business OTHER SKILLS and ABILITIES: Strong clinical, management, communication, and organizational skills. Demonstrated leadership skills Analytic skills Energetic and curious with a passion for quality and value in health care Required to pass skills proficiency test 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 $68-$74/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!

**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 Will 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 **Qualifications - Required:** + 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 + **This role is Monday- Friday from 9:00 am to 6:00pm, CST, MST or PST. with some flexibility. Additionally rotating on-call support, including after-hours, weekends and holidays.** **Qualifications - 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 $28.00 to $31.00. 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!

**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!

**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:** The Managing Director, Strategic Accounts role is a dynamic, fast paced position, serving as the single executive accountable for client health, strategy, success, and growth. This role provides the opportunity to own a book of client specific P&Ls including retention, expansion, and operational efficiency. It is a player coach role providing the opportunity to foster executive relationships at client accounts and lead a team of account directors and managers. **Who You'll Be Working With:** The Managing Director, Strategic Accounts embodies the Evolent value "Start by Listening," forging deep relationships and serving as a trusted C-suite advisor to Evolent's partners. This role also work in a highly cross-functiona capacity, including with key leaders and team members in our Operations and Provider Solutions teams. We are looking for a candidate with a strong entrepreneurial spirit to oversee strategic partnerships with a pool of large, multi-state and/or multi-line of business health plans. This role will report to Evolent's Chief Customer Officer **The Day-to-Day** + Serving as a strategic advisor and consultative partner, helping to identify opportunities for more impactful management of health plan's specialty care initiatives.; Managing the commercial process for these growth opportunities in collaboration with Business Development, Corporate Development and Operations leaders + Developing and orchestrating market-specific and enterprise performance initiatives; flagging risks for risk partner performance relative to financial goals + Managing a team of high-performing account leads, ensuring consistent market/client governance and appropriate allocation of team resources. + Taking responsibility for the satisfaction, retention, and growth of a portfolio of Evolent solutions across this account. Cultivating productive, trusted relationships with key partner executives and stakeholders + Owning the strategy and execution of the commercial process for contract management, negotiation, and renewals. Running regular Account Strategy Planning efforts, including relationship mapping, issue identification, and action planning + Proactively assessing, validating, and prioritizing partner needs on an ongoing basis, channeling input from partners into Evolent's product roadmap and strategy + With Operations and Provider Solutions teams, monitoring issue resolution and ensuring appropriate, timely follow up by Evolent team members; advocating on behalf of partner within Evolent to overcome challenges to partner value and ensuring Evolent addresses root causes of satisfaction issues + Advocating for partner culture, serving as an ambassador within Evolent and acting as the subject-matter-expert on partner priorities and getting things done within the partner organization **Qualifications:** + 10+ years in relationship management roles (consulting, enterprise sales, account management, etc.) + Bachelor's degree OR equivalent work experience. + Commercial / business development acumen to identify and close growth opportunities + Demonstrated ability to effectively communicate and present at all levels of the organization, including at the C-level. Influence through effective stories to emphasize the value proposition of the partnership. + Strong command of the financial elements of value-based care businesses and an ability to package this analysis into a compelling value proposition for specific growth opportunities and the partnership overall + A tenacious partnership ethos with a relentless focus on follow through and maintaining trust + The intellectual curiosity to get to the bottom of partner issues and opportunities and the willingness to roll up sleeves and work toward solutions in partnership with operations counterparts and centralized resources + Ability to manage heavy travel schedule, including ~3 days a week in-market at our partner organizations 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 $160,000-180,000. 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!

**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:** Responsibilities + Design, develop, test, and maintain software applications using modern programming languagesand frameworks. + Collaborate with product managers, designers, and other engineers to translate requirementsinto technical specifications. + Write clean, maintainable, and efficient code, following best practices and coding standards. + Participate in code reviews to ensure code quality, functionality, and maintainability. + Troubleshoot, debug, and resolve technical issues and bugs in a timely manner. + Optimize applications for maximum performance, scalability, and reliability. + Contribute to the continuous improvement of development processes, tools, and + methodologies. + Stay up-to-date with emerging technologies and industry trends, and apply them to improve ourproducts and solutions. Requirements + Bachelor's degree in Computer Science, Software Engineering, or a related field, or equivalent + practical experience. + Proven experience in software development using languages such as C#, Java, Python, JavaScript,etc. + Strong understanding of software design principles, algorithms, and data structures. + Experience with front-end frameworks (e.g., React, Angular, Vue) and/or back-end technologies(e.g., Node.js, Django, Spring). + Familiarity with version control systems such as Git and collaborative coding workflows. + Experience with cloud platforms (e.g., Azure, AWS, Google Cloud) and containerization tools + (e.g., Docker, Kubernetes). + Ability to write unit, integration, and end-to-end tests to ensure code quality and reliability. + Excellent problem-solving skills and the ability to work independently and as part of a team. + Strong communication skills with the ability to articulate technical concepts to both technicaland non-technical stakeholders. 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 $73,200 - 102,500. 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!

**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:** **Lead the Transformation in Oncology Care** At Evolent, we're redefining how care is delivered for individuals facing cancer. As a Performance Suite Medical Director in Medical Oncology, you will play a pivotal role in advancing value-based care models that prioritize clinical excellence, patient-centered outcomes, and system-wide impact. This role offers the opportunity to collaborate with top-tier clinicians, influence care pathways, and drive innovation in one of the most critical areas of health care. If you're passionate about making a measurable difference in oncology, this is your platform to lead with purpose. In this role, you will combine your clinical oncology expertise with a focus on **value-based strategy and transformation** . Unlike traditional medical review roles that emphasize volume throughput, this position integrates utilization management with collaborative engagement and innovation. **Core Responsibilities** + **Clinical Review & Peer Collaboration** + Serve as the physician reviewer for oncology cases that do not initially meet medical necessity criteria, applying evidence-based guidelines to ensure high-quality and cost-effective care. + Conduct peer-to-peer discussions with requesting oncologists-not only to explain determinations but to **partner in driving practice patterns aligned with value and quality outcomes** . + Support clinical reviewers as a subject matter expert and resource. + **Practice & Physician Engagement** + Actively participate in **engagement sessions with oncology practices** , sharing best clinical practices and supporting broader adoption of evidence-based pathways. + Foster trusted peer relationships with oncologists to encourage **sustainable behavior change** that improves patient outcomes. + Support practice-level transformation initiatives that reduce unwarranted variation and enhance quality. + **Internal Strategy & Value Initiatives** + Collaborate with Evolent's clinical leadership on the **design, build, and execution of new value initiatives in oncology** . + Provide input on innovation opportunities, clinical algorithms, and models of care that support transformation in specialty care. + Partner with operational and analytic teams to assess the impact of interventions and identify opportunities for continuous improvement. + Participate in audit processes to validate accuracy of advance payment model payouts, ensuring alignment with clinical documentation, performance metrics, and contractual expectations. + **Compliance & Quality** + Ensure all reviews and engagements align with URAC, NCQA, and internal quality standards. + Document peer interactions and clinical decisions in a timely and accurate manner. + Participate in training and inter-rater reliability processes. **Qualifications** + MD/DO/MBBS with board certification in **Medical Oncology** . + Minimum five (5) years' post-residency experience, with active clinical practice preferred within the past 2 years. + Current, unrestricted medical license (multiple state licenses preferred or willingness to obtain). + Demonstrated **leadership in practice transformation, value-based care, or clinical quality improvement** . + Strong communication, collaboration, and organizational skills, with proven ability to influence physician behavior. + Energetic, curious, and passionate about **shaping the future of oncology care delivery** . + Not under sanction or exclusion from Medicare/Medicaid programs. 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 $120-130/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!

**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 **Director, Service Excellence** Evolent is looking to hire a Director of Service Excellence. This individual will serve on a central team within the customer organization focused on ensuring that we deliver best-in-class service to our customers. The director will be a key connection point into cross-functional teams, representing the customer team on key issues and initiatives representing multiple partners. **Who You'll Be Working With:** The person in this role will be responsible for managing incident response, ensuring that we are addressing issues in a timely manner, monitoring outbound documents to facilitate clear and consistent messaging around our value and performance, leveraging internal SME's to educate customer-facing teams on key initiatives that drive value, and ensuring that we are providing transparent and proactive communication to our customers. **What You'll Be Doing:** + Manage voice of customer insight gathering through survey administration and customer specific primary research + Facilitate internal forums to promote alignment and accountability across internal teams (e.g., SLA timelines, product performance and value, data monitoring / platform issues, etc.) + Serve as the main customer point of contact for key initiatives with a focus on solutioning, streamlining processes and working cross-functionally to ensure timely execution + Coordinate customer communication (payer and provider) on key initiatives, projects, or issues/incidents that impact service delivery + Develop an "issue resolution" playbook, promoting consistent definitions of problem types and standardizing solutioning + Ensure SLA's are maintained via a central database, instilling best practices for monitoring and managing across the customer org + Monitor internal issue ticketing system / reporting to ensure key customer issues are being addressed in a timely manner **The Experience You'll Need (Required):** + 5+ years of experience in account management or client services role in digital health, healthcare, payer + Previous experience managing a team of direct reports + Strong track record of high client satisfaction, growth and retention + Strong verbal, written and presentation skills; ability to communicate clearly and influence internal and external stakeholders + Strong analytical skills; ability to understand data and present information accordingly + Experience working in a cross-functional capacity + Strong leadership and effective problem abilities; must be able to develop and grow relationships with executive leaders, and internal cross-functional teams 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!