Job details
Job type full-time
Full job description
It’s time for a change…
Your future evolves here
Evolent health has a bold mission to change the health of the nation by changing the way health care is deliveredOur pursuit of this mission is the driving power that brings us to work each dayWe believe in embracing new ideas, testing ourselves and failing forwardWe respect and celebrate individual talents and team winsWe have fun while working hard and evolenteers often make a difference in everything from scrubs to jeans.
Are we growing? absolutelyWe have seen about 30% average growth over the last three yearsAre we recognized? definitelyWe were named one of “becker’s 150 great places to work in healthcare” in 2016, 2017, 2018 and 2019 and are proud to be recognized as a leader in driving important diversity and inclusion (d&i) efforts: evolent achieved a 95% score on its first-ever submission to the human rights campaign`s corporate equality index; was named on the best companies for women to advance list 2020 by parity.org; and we publish an annual diversity and inclusion annual report to share our progress on how we’re building an equitable workplaceWe recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each dayIf you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a missionJoin a mission with a company behind it.
What you’ll be doing:
Provide leadership and guidance to the system configuration managers who are responsible for overseeing the development of configuration builds, including benefit and payment rules, provider reimbursement and structures, and system parameters that accurately process and pay claims as specified in client contracts.
Define and ensure departmental and corporate goals related to client service levels agreements are met.
Build scalable health plan configuration delivery to support multiple clients
Develop and measure proficiency across benefit and pricing system configuration
Partner with department leader(s) to execute on configuration roadmap
Delivery oversight for configuration teams during a new client implementation & maintenance scope of work – planning, scoping, execution, risk/issues, coordination etc.
Capacity planning of resources and raise flags for any major gaps
People management responsibilities like performance management, career pathing, general administration (time, expenses, vacations etc.) for direct reports
Partner with various stakeholders to level set current state of configuration work, raise issues/risks anticipated with delivery and orchestrate delivery in a highly matrix environment
Assess current delivery capabilities and identify opportunities to expand utilization of pune system configuration skill set.
Enhance system configuration capability in various areas where there is a need for long term business need
Coach managers/supervisors and hire and retain top talent
The experience you’ll need (required):
Extensive experience in health insurance claims processing and system configuration with a minimum of 7 to 9 years management experience.
12+ years of experience in health insurance claims processing and system configuration in new implementation or maintenance projects
12+ years of experience in plan building, provider data maintenance and reimbursement methodologies including fee schedules, contract management and workflow processes.
Managed care, commercial or medicaid experience.
Understanding of the healthcare industry, including competitors, the regulatory environment, and industry trends
Advanced skill level of microsoft office suite (excel, word, power point)
Leadership skills: decision making, negotiation, ability to lead, coach and mentor
Foster a trusting and safe environment with an emphasis on problem solving and continuous improvement
Model servant leadership: inspire the team, take an active role in setting the team up for success
Evolent health is an equal opportunity/affirmative action employer
Technical requirements:
Currently, evolent employees work remotely across all fity (50) states due to covid-19As such, we require that all employees have the following technical capability at their home: high speed internet over 10 mbps and, specifically for all call center employees, the ability to plug in directly to the home internet routerThese at-home technical requirements are subject to change with any scheduled re-opening of our office locations.
“evolent health is committed to the safety and wellbeing of all its employees, partners and patientsWe currently require all employees who may voluntarily return to our evolent offices to be vaccinated and invite all employees regardless of vaccination status to remain working from home.
As we continue to evaluate re-opening our offices more fully and begin to have specific roles that will require face to face interaction with our providers and patients in client facilities or homes, all employees must be prepared to meet our vaccine requirements with or without accommodation at that time.”
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.
