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Virginia, United States
Remote only
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:
A Sr Analyst works on the creation of insights and sharing of information with different stakeholder groups within Evolent and Evolent’s partners.
Data Analysis & Interpretation:
• Analyze healthcare utilization, authorization, and claims data to identify trends, cost drivers, and opportunities for improvement.
Perform complex data analysis using SQL, PowerBI or Excel to support internal and external stakeholders.
• Update, review, and maintain actuarial or financial models to support gainshare and ROI arrangements, as well as forecasting.
Reporting & Visualization:
• Develop and maintain reports, dashboards, and performance metrics using tools like SQL, PowerBI, and Excel.
• Automate and optimize recurring reports and ad-hoc analyses.
• Review and QA output, identify trends independently, and communicate key information to teams outside analytics.
• Create exhibits and presentations that document, summarize, and communicate results of financial analyses or actuarial modeling.
Stakeholder Collaboration:
• Partner with internal teams (e.g., Clinical Ops, Product, Finance) and external clients to gather requirements and deliver actionable insights.
• Develop custom ad hoc logic with direction from client or customer stakeholders with oversight.
• Participate in standups, client calls, and cross-functional project teams.
Communication & Presentation:
• Clearly communicate findings to non-technical audiences.
• Create polished presentations and narratives that highlight key insights and recommendations.
Problem Solving & Strategic Insight:
• Translate business questions into analytical problems and deliver data-driven solutions.
• Identify data gaps, propose solutions, and guide resolution efforts.
Process Improvement & Innovation:
• Identify opportunities to improve data reliability, reporting efficiency, and analytical methodologies.
• Peer review others reports and presentations for consistence, alignment and formatting and train more junior team members in presentation best practices.
• Contribute to the development of scalable, repeatable analytics solutions.
Domain Expertise Development:
• Build and apply knowledge of U.S. healthcare systems, including claims, reimbursement models, and regulatory frameworks.
• Stay current on industry trends and best practices in healthcare analytics.
• Bachelor's degree.
• 4+ years of experience in healthcare data analysis or similar role.
• Strong proficiency in SQL, Excel and data visualization tools, including the ability to join multiple data sources and use pivot tables and aggregation methods to summarize data across multiple dimensions.
• Proficiency with healthcare data including medical, pharmacy, and ancillary claims data, membership data, clinical operational data (UM & CM), or other healthcare data.
Preferred Qualifications
• Experience with value-based analyses or Medicaid
• Experience with financial analysis, forecasting or actuarial analyses
• Exceptional analytical and mathematical skills
• Ability to communicate complex analyses effectively
• Demonstrated problem solving skills and attention to detail
• Ability to excel in highly matrixed environment and adapt to change
• Bachelor's degree with a quantitative (e.g., actuarial, statistics, operations research, engineering, mathematics, economics, finance) or healthcare (e.g., health administration, epidemiology, public health, biology) focus or major.
Preferred Certifications
• Progress towards Associate of the Society of Actuaries
As a Sr Functional Analyst, Clinical Analytics, you will be required to fulfill your responsibilities while meeting the following general performance criteria for this position at this level:
Expertise: You are a go-to resource for certain methods and take initiative to add to your list of specialties.
Communication: You seek to achieve clarity regardless if you are the source of the information being conveyed to the participants in the communication.
Domain: You guide the delivery of your team to make a positive impact on other parts of the company based on detailed knowledge of the needs of those stakeholders and how those needs are supported by your team.
System: You own relevant segment of systems that are used regularly for the business to function and are well versed in the related KPIs.
Process: You question the status quo in a constructive manner to find areas for the team to improve.
Influence: You regularly make an impact to your entire team.
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.
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 recruitingteam@evolent.com for further assistance.
The expected base salary/wage range for this position is $. 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.