Experience:
3-5 years of experience
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Employment Type:
Full time
Posted:
6/16/2019
Job Category:
Analysis
Business Analyst
(This job is no longer available)
Evolent Health, Inc. | Chicago, IL
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Job Description

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 force that brings us to work each day. We believe in embracing new ideas, challenging 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-56.7% in year-over-year revenue growth in 2016. Are we recognized? Definitely. We have been named one of "Becker's 150 Great Places to Work in Healthcare" in 2016 and 2017, and one of the "50 Great Places to Work" in 2017 by Washingtonian, and our CEO was number one on Glassdoor's 2015 Highest-Rated CEOs for Small and Medium Companies. 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.

Position Summary

The Senior Analyst of Enrollment Operations is responsible for finding ways to improve the accurate and expedient processing of all membership transactions of On-Exchange, Off-Exchange, and various Commercial lines of health benefit administration. This requires ongoing analysis and supervision of activities and deliverables that will improve enrollment operations. This includes, but may not be limited to: new implementation support, file load processes, evaluation of existing business operations, reviewing compliance with all relevant regulatory agencies, monitoring achievement of operational service levels and other special projects. The Senior Analyst will be called upon to provide assistance to upper management for projects and special assignments, and is accountable for establishing and maintaining productive relationships with internal departments across Evolent Health.

Essential Functions

* Assist the director in analyzing department performance and processes, and developing new operational processes and recommendations for improvements.
* Provide guidance for team and management regarding escalations and help to proactively resolve issues before they occur.
* Develop, refine and implement effective policies and procedures, and subsequent training, to ensure all team members are able to perform properly.
* Assist with new client implementation support to ensure timely, accurate delivery enrollment data, claim data entry, system set-up, cross-departmental communication, standard reports, and exception reporting.
* Develop knowledge in ACA Exchange, Centers for Medicare & Medicaid Service, Self-Funded, and all other applicable regulatory agencies that govern the enrollment data both received via electronic data interface (EDI) and non-EDI.
* Identify way to improve ongoing reconciliation of group and agency enrollment data; including proactively reporting and resolving discrepancies.
* Assist the director in developing and analyzing appropriate team performance metrics.
* Promote the use of accepted best practices and innovative strategies.
* Keep abreast of changes in requirements.
* Assist the team in resolving administrative and routine operational issues as they arise

Education and Experience

* 4 year College degree or equivalent work experience

Skills:

* Understanding of X12 files, 834 files, paper enrollment, and billing/invoicing.
* Understanding of claim processing environment and knowledge of claim adjudication process/concepts.
* Experience in process improvement that utilizes six sigma, kaizen, and/or other process improvement methodologies in a transactional environment or has experience in being involved in process improvement in general that tie into measureable results.
* Overall understanding of health care benefit administration.
* Ability to communicate in an effective manner to drive results and maintain positive team atmosphere.
* Ability to communicate to other internal business teams during cross-functional projects and ability to implement conflict resolution strategies.
* Ability to document processes and/or provide guidance to business analyst to ensure proper documentation is developed.
* The interpersonal skills necessary include the ability to work well within a team that includes all levels within the organization from clerical and support staff to senior management as well as clients and brokers outside of the organization.
* Understands working in a health benefit administration, Third Party Administrator, or Pre-Tax Benefit environment
* Understands and can work in a production environment in which performance is tied to operational metrics
* Integrity and discretion to maintain confidentiality of member's HIPAA data.
* Strong analytical ability necessary to work, discover and outline systems related issues on own as well as within a team.
* The ability to take the lead on projects and recommend and implement process to complete work.
* Proficient in MS Excel and MS Word.

Work Environment

The work environment; temperature, noise level, inside or outside, or other factors that will affect the person's working conditions while performing the job. For example, this job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Physical Demands

Include the physical demands of the job, including bending, sitting, lifting and driving. For example, while performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms.

We are a work hard, play hard company, with a mission to help change healthcare. We are committed to treating our employees well, knowing that they in turn will treat our clients well, and help them provide higher quality, lower cost healthcare. With 1000+ employees located in Chicago and three other office locations, Eevolent Health is a small, but growing company doing big things.

Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.