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.
Who You’ll Be Working With:
The Director of EDI Services position will service Evolent Health’s Health Plan Services (HPS) business unit. Reporting to the VP HPS IT Operations, the mission of the Director is to provide the appropriate program management for new and existing client EDI implementations, contribute to the ongoing improvement of the existing EDI strategy to support the HPS operations, provide project oversight across multiple vendors, and contribute to the design and development of EDI application interfaces and standards. This role will be based in Chicago, and may have periodic interactions with external clients.
What You’ll Be Doing:
- Serve as the business unit’s healthcare EDI/x12 Subject Matter Expert providing support across new client implementations, x12 trading partner management, business process improvement, and Level 3 EDI issue escalation/production support
- Provide project governance for all aspects of EDI implementations, spanning multiple departments within the HPS organization
- Communicate effectively with internal and external stakeholders
- Provide oversight for the configuration of EDI trading partners within multiple technology platforms, including Evolent Health’s claims management platform and enterprise service bus (ESB)
- Support and foster a collaborative team environment, with a focus on being change agents for new and innovative business processes associated with the variety of EDI transaction sets
- Grow the EDI expertise throughout the IT and business operations organizations
- Effectively manage relationships and processes with third party vendors
The Experience You’ll Need (Required):
- Should have at least 5-8 years of experience in a healthcare setting, preferably within a managed services organization or health plan
- Exposure to HIPAA/EDI X12 v5010 healthcare-related file formats including 820,834, 835, 837, 270, 271, 276, ,277, 278, 997, 999 and 824 is strongly preferred
- Possess a strong knowledge of claims, enrollment, and premium business processes in a commercial, Medicare, or Medicaid health plan/TPA organization
- Demonstrated record of accomplishment guiding projects to successful completion: on time, on budget, on plan
- Familiarity with regulatory requirements associated with HIPAA, CAQH CORE, ICD-10, and the Affordable Care Act
- Expert knowledge of industry standard health data code sets such as ICD-9/ICD-10, CPT/HCPCS, and Revenue Codes
- Exposure to commonly used EDI and ETL concepts, practices and procedures within a heath care field
- Possess analytical and creative problem solving skills
- Strong verbal and writing communication skills – technical, non-technical, and user friendly
- Ability to work independently and self-motivated in a dynamic, fast-paced environment
- Leadership, communication, interpersonal skills coupled with strong customer driven orientation
- Familiarity with Quality Assurance concepts and test plan development
- Requires a technical, business, or scientific Bachelors’ Degree
Coupled with one’s experience are the personal qualities, which determine an individual’s ability to lead and be credible with internal and external audiences.
Style: Concise. Persuasive. Pragmatic. Disciplined. Excellent communicator and team contributor. Able to embrace and enjoy a highly collaborative environment. True believer and practitioner of servant-centered leadership. Driven, self-motivated innovator. Intellectually curious. Highly professional persona and polished demeanor.
Values: Integrity, trust, respect, passion, collaboration.
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.