Claims, Audit and Recovery
Analyst, Claims Operations
Chicago, IL, United States

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—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.

What You’ll Be Doing:

We are looking for a bright and energetic individual for a Claims Operations Analyst in our claims department.  This position involves the preparation and analysis of claims data with an emphasis on claims inventory and performance metrics. The Analyst, Claims Operations will:

  • Develop reports to track claims related metrics, such as inventory, productivity and timeliness
  • Identify process improvement opportunities and lead or contribute to related projects
  • Analyze data and format solutions towards inventory reduction
  • Compile and organize healthcare data from multiple sources
  • Partner with claims and other stakeholders to develop daily inventory plan based on available resources, priorities and timeliness requirements, across clients
  • Monitor and manage claim processing plan and modify/realign resources as required to meet the objectives
  • Develop clear and well-structured analytical plans
  • Identify, communicate and resolve data gaps that impact the fulfillment of claims objectives
  • Document, track and resolve issues related to claims data quality
  • Act as liaison with configuration to resolve claim issues and identify and implement continual process improvement activities
  • Support and contribute to projects and/or operational improvement activities


The Experience You’ll Need (Required):

  • Strong analytical skills with the ability to collect, organize, analyze, and disseminate significant amounts of information with attention to detail and accuracy
  • Possess the desire to advance and grow personally and professionally
  • Must have a passion for data and dedication to internal and external customers
  • Work successfully in a team setting towards meeting common objectives
  • Proficient in MS WORD, EXCEL and MS Office applications
  • Ability to multi-task and meet deadlines in a fast-paced environment
  • Ability to access data in varied formats with different methods of analyzing and processing data
  • Bachelor’s degree or equivalent claims/healthcare work experience
  • 3-5 years experience in health plan operations preferably in claims

Finishing Touches (Preferred):

  • Proficiency with the Aldera claims processing platform preferred


Evolent Health is an Equal Opportunity/Affirmative Action Employer

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