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Evolent Health Supervisor, Provider Data Management in Boston, Massachusetts

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 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 – about 40% in year-over-year revenue growth in 2018. Are we recognized? Definitely. We have been named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016, 2017, 2018 and 2019, and one of the “50 Great Places to Work” in 2017 by Washingtonian. 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:

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:

Under direction of the Manager or Director, Provider Data Management, this position is responsible for the supervision of day to day operations, as well as, continuing to perform provider enrollment and data management activities, as necessary.

  • Demonstrate working knowledge of current federal and state regulations as well as internal business requirements pertaining to credentialing, recredentialing, and provider enrollment with the Health Plan using NCQA, Medicaid and Medicare guidelines

  • Maintain current working knowledge of the National Committee for Quality Assurance (NCQA) guidelines related to credentialing and recredentialing requirements

  • Participate in the development, implementation and ongoing review of departmental policies and procedures

  • Maintain departmental resource guide and assist with training associates to ensure consistency with performing business processes

  • Participate in review of business processes; identify opportunities for improvement; initiate implementation and training of associates as applicable

  • Acts as liaison between department management, other internal departments, subordinates, and external contacts

  • Analyze departmental metrics for monitoring productivity, quality and timeliness of provider enrollment activities in support of proactively identifying gaps in business processes

  • Oversee weekly provider enrollment submissions to credentialing software and claims processing system

  • Monitor departmental email and route for processing, as necessary

  • Process applications for provider enrollment, as necessary

  • Provides guidance and support to staff personnel towards resolution of problems with an emphasis on root cause analysis and resolution of problems

  • Supports staff with the resolution of daily issues

  • Supervise direct staff reports, as assigned

  • Responsible for performance appraisals of all direct reports, as assigned

  • Performs other duties, as assigned

Job Requirements:

  • Ability to represent the department effectively with supporting teams

  • Demonstrate problem solving, critical thinking, and process analysis skills to support teams responsible for client configuration

  • Possess willingness to learn and develop understanding of configuration best practices

  • Willingness to escalate issues that may impact team productivity or confusion on priorities

Key Competencies/Success Factors:

  • Lives the values: Integrity, Community, Collaboration and Stewardship, as defined in the performance appraisal

  • Proficient PC skills in a Microsoft Office based environment

  • Excellent verbal and written communication skills

  • Detail oriented with good organizational skills and ability to enter data with accurately in a timely manner

  • Ability to work collaboratively with associates and other departments

  • Ability to handle multiple projects simultaneously

  • Ability to adapt to fluctuating situations and perform work of a detailed nature, avoiding errors

The Experience You’ll Need (Required):

  • Bachelor’s degree preferred

  • Minimum of two years’ experience in healthcare field related to credentialing, provider enrollment, providers services and/or configuration

  • Experience with enrolling providers in state Medicaid programs

  • 3 – 5 years of accurate data entry and maintenance of claims processing systems and databases, specific to credentialing, provider enrollment, provider services or configuration

  • Prior Team Lead or Supervisor experience

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.

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 committed to the safety and wellbeing of all its employees, partners and patients and complies with all applicable local, state, and federal law regarding COVID health and vaccination requirements. Evolent expects all employees to also comply. We 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. Certain jobs require face-to-face interaction with our providers and patients in client facilities or homes. Employees working in such roles will be required to meet our vaccine requirements without exception or exemption.

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.

Compensation Range:

The typical range of employees within the compensation grade of this position is . Salaries are determined by the skill set required for the position and commensurate with experience and may vary above and below the stated amounts.

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