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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 Specialist, Provider Data Management will be a dynamic role that will encompass overall support and maintenance of provider data. We value curiosity, creativity, and independence as we work collaboratively to solve complex problems.

**Collaboration Opportunities** :

This role works closely with our Evolent partners to support data management, claims processing, and other activities that are within scope. You will work closely with teams such as Claims, Configuration, and Enrollment/Eligibility to ensure timely and accurate data loads and claims processing occurs.

**What You’ll Be Doing** :

+ Maintenance of provider data within the claims processing system.

+ Managing credentialing variables and demographics and contract or fee schedule. assignments based on provider updates submitted by clients.

+ Work and troubleshoot claims that are suspended in provider data work queues.

+ Responsible for managing concurrent projects as assigned.

+ Establishing and maintaining excellent relationships, internally and externally

+ Working on special projects.

+ Communication to management.

+ Maintain contractual service level and/or operational level agreements, as applicable.

What You Bring:

+ BA preferred or equivalent years of experience with a quantitative emphasis.

+ Minimum of one to two years' experience in the healthcare field related to credentialing, provider enrollment, provider services, and/or configuration is required.

+ Lives the values: Communicate with candor, Start by Listening, Foster Inclusion, and Own the Opportunity.

+ Prior experience with process improvement methodologies.

+ Prior experience with quality management and data comparison/analysis using Microsoft Excel.

+ Proficient PC skills in the following Microsoft Office-based environments: Excel, Word, PowerPoint, Teams, OneNote, and Outlook.

+ Detail-oriented with good organizational skills.

+ Update provider data with accuracy and complete quality review in a timely manner.

+ Takes initiative and works independently with a strong ability to time manage and reprioritize tasks/projects as appropriate, working in an agile space and adapting to fluctuating situations.

+ General understanding of US health care, Managed Care Organizations, and/or Medicaid.

To comply with HIPAA security standards (45 C.F.R. sec. 164.308 (a) (3)), identity verification may be required as part of the application process. This is collected for compliance and security purposes and only reviewed if an applicant advances to the final interview state. Reasonable accommodations are available upon request.

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** **[email protected]** **for further assistance.

The expected base salary/wage range for this position is $27.00-29.00/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.

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