Healthcare & Clinical
Associate Director, PDS
Pune, Maharashtra, India

It’s Time For A Change…

Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving power that brings us to work each day. We believe in embracing new ideas, testing ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.

Are we growing? Absolutely. We have seen about 30% average growth over the last three years. Are we recognized? Definitely. We were named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016, 2017, 2018 and 2019 and are proud to be recognized as a leader in driving important Diversity and Inclusion (D&I) efforts: Evolent achieved a 95% score on its first-ever submission to the Human Rights Campaign's Corporate Equality Index; was named on the Best Companies for Women to Advance List 2020 by Parity.org; and we publish an annual Diversity and Inclusion Annual Report to share our progress on how we’re building an equitable workplace. We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.

What You’ll Be Doing:

Evolent Health is looking for an Associate Director of Health Care Payer Data to be a key member of the technology leadership team. This individual will play a critical role in executing Evolent Health’s mission by managing data-driven activities related to data profiling, data discovery and analysis, requirements definition, testing and continuous improvement of data collection, mapping, analysis and transformation processes specifically related to implementation of new client data portfolios. 

Essential functions:

  • Gain familiarity and knowledge of the Evolent administrative data lifecycle from requirements through data analysis to engineering and testing. Learn through hands-on work how each function works to become SME in each area
  • Analyze data files, data layouts and data dictionaries from providers of health care administrative data (eligibility, account/plan, medical claims, pharmacy claims, etc) to understand data structure and operating rules for transforming to common data format
  • Conduct in-depth interviews with data providers (client or payer staff) to ensure comprehensive understanding of data operating logic and data provided
  • Author data mapping and transformation requirements based on understanding of operating rules; review with ETL engineers and testers to ensure adequate turnover
  • Produce detailed data quality profiles from client health care administrative data to validate structure, content and overall data quality; present findings to internal stakeholders for signoff and/or escalate critical data issues as necessary
  • Serve as subject matter expert in primary data domain relative to client’s data and transformation rules; back up analysts in other data domains as workloads and priorities necessitate
  • Collaborate with data warehouse QA team to ensure seamless execution of test cases end-to-end
  • Liaise with onshore implementations team to ensure best practices are followed and issues/concerns are addressed proactively
  • Mentor analysts and junior level resources in best practices and guidelines for implementations and data analysis; aid in development of learning activities
  • Alert service delivery managers to potential risks to project and timelines along with issues of importance

 

Preferred functions

 

  • SAS skills for querying datasets and reporting
  • A knack for dealing with healthcare datasets and finding relationships in the data and any gaps/issues
  • Patience and persistence to sift through complex data/information to get to the core knowledge
  • Experience with clinical coding systems: ICD diagnosis codes, ICD procedure codes, CPT codes, revenue codes, provider NPI codes, NDC Rx codes.
  • Knowledge of medical claim file contents (both UB04 and HCFA-1500) and significance of individual fields
  • Experience in analyzing, defining and documenting business processes and rules
  • Experience testing data and creating related test cases
  • Proven track record in establishing strong relationships with internal stakeholders, clients and vendors
  • Intense intellectual curiosity and an ability to view problems with a fresh perspective
  • Excellent written computer and oral communication skills

 

 

Finishing Touches (Preferred):

 

  • 8+ years of experience in information technology
  • Bachelor's Degree required
  • SQL skills to write queries, join tables to view/test data in a relational database
  • Understanding of Medical Claims, Rx Claims, Eligibility/Membership, healthcare insurance benefit and group account setup, Provider data and related processes around them

 

Technical requirements:

Currently, Evolent employees work remotely temporarily due to COVID-19. As such, we require that all employees have the following technical capability at their home: High speed internet over 10 MBPS 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 Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.

 

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