The Market Operations Analyst acts as a liaison between operational leaders and delivery teams to translate business needs into actionable requirements. They are responsible for managing business process documentation, facilitating stakeholder discussions, and ensuring operational readiness for strategic initiatives.
Evolent
38 Remote Job Openings at Evolent
This position involves managing and supervising clinical staff performing utilization management reviews within the medical oncology specialty. The manager will also coordinate quality improvement activities, oversee staff performance, and assist in the development of strategic and operational goals.
The Lead Software Engineer will design, develop, and maintain enterprise-grade healthcare applications while providing technical leadership to the team. They are responsible for driving performance optimization, mentoring junior engineers, and collaborating with stakeholders to deliver high-quality features.
Design and develop scalable backend services and data ingestion pipelines using Python and Azure services. Collaborate with Agile teams to build healthcare-focused software solutions and optimize legacy SQL stored procedures.
Oversee key strategic initiatives for Evolent and its partners, focusing on operational execution, risk mitigation, and value optimization. The role involves shaping enterprise-wide strategy, managing financial risks, and guiding stakeholders through data-driven decision making.
Manage the day-to-day operational aspects of Medical Policy processes and support the publication of clinical guidelines. Collaborate with cross-functional teams to ensure the timely and accurate delivery of high-quality clinical guideline products.
Sr Advisor, Practice Performance (West Coast or Central Region)
Evolent
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Full Time
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13 days ago
Evolent
Leads provider onboarding and strengthens relationships to drive performance improvement across markets. Serves as the primary liaison to manage operational workflows and oversee the FastPass performance program.
Serve as a physician reviewer for Hip, Knee, and Shoulder surgery cases to determine medical necessity. Conduct peer-to-peer discussions with providers and ensure compliance with URAC and NCQA guidelines.
Manage the full lifecycle of SaaS applications with a focus on AI-driven automation and optimization of Atlassian platforms. Ensure security, governance, and regulatory compliance within a HIPAA-compliant environment.
Drive the strategy, design, and delivery of technology solutions for Utilization Management and provider portal applications. Lead agile teams to translate strategic goals into actionable requirements while ensuring regulatory compliance.
Oversee actuarial quality and rigor across analytics and finance teams to ensure models are sound and defensible. Drive process improvements and workflow efficiencies to reduce manual effort and scale analytical outputs.
The Lead HRIS Analyst is responsible for the maintenance, enhancement, and optimization of the Workday HCM system. This includes configuring business processes, developing custom reports, and mentoring team members to improve HR efficiencies.
Serve as a specialty match reviewer for vascular cases to determine medical necessity and conduct peer-to-peer discussions with providers. Ensure compliance with URAC and NCQA guidelines while providing clinical rationale for appeals.
The role involves building headcount models and financial packages to support operational decision-making for the Operations Finance team. It requires collaborating with cross-functional stakeholders to report performance trends and contribute to annual budgeting and monthly forecasting.
Lead and manage AI initiatives to transform healthcare operations, specifically focusing on the Auth Intelligence application. Coordinate between data science, clinical, and technical teams to translate model outputs into scalable product features.
Staff Accountant (CA/Chartered Accountant OR CPA mandatory)
Evolent
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Full Time
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a month ago
Evolent
The role involves owning India GAAP financial statements, managing local AP/AR teams, and leading statutory and tax audits. Additionally, the position supports global accounting tasks, budgeting, forecasting, and ensures local regulatory compliance.
Lead vascular-focused provider engagement and practice transformation efforts to improve clinician engagement and group performance. Act as a strategic partner to vascular groups and health plans to align clinical programs and enhance care quality.
The role involves providing data-driven financial and operational analyses to support strategic decision-making for executive leadership and the Board of Directors. Key duties include developing financial models, managing department budgets, and automating financial reporting tools.
The Assistant Financial Controller provides financial oversight by preparing India GAAP financial statements and managing payroll and statutory compliance. Additionally, the role oversees the procurement team and manages vendor data and strategic purchase order directions within the Workday system.
Serve as a physician reviewer for imaging cases to determine medical necessity and conduct peer-to-peer discussions with providers. Ensure compliance with URAC and NCQA guidelines while providing clinical rationale for appeals.
The Principal Product Solutions Architect provides senior product judgment to ensure customer solutions are product-coherent, commercially sound, and operationally sustainable. This role acts as a governance bridge between Sales, Product, and Delivery to prevent non-standard commitments and reduce downstream complexity.
Endocrinology-Physician Reviewer-Field Medical Director, Radiology (Full-Time)
Evolent
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Full Time
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2 months ago
Evolent
Serve as a physician reviewer for imaging cases to determine medical necessity and conduct peer-to-peer discussions with providers. Ensure compliance with URAC and NCQA guidelines while providing clinical rationale for appeals.
Otolaryngologist-Physician Reviewer-Field Medical Director, Radiology (Full-Time)
Evolent
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Full Time
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2 months ago
Evolent
Serve as a physician reviewer for imaging cases to determine medical necessity and conduct peer-to-peer discussions with providers. Ensure compliance with URAC and NCQA guidelines while providing clinical rationale for appeals.
Physician Reviewer Internal Medicine-Field Medical Director, Radiology (Part Time)
Evolent
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Full Time
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2 months ago
Evolent
Serve as a physician reviewer for imaging cases to determine medical necessity and conduct peer-to-peer discussions with providers. Ensure compliance with URAC and NCQA guidelines while providing clinical rationale for appeals.
Field Medical Director, Radiation Oncology (full-time or part-time)
Evolent
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Full Time
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2 months ago
Evolent
Serve as a physician reviewer for Radiation Oncology and imaging cases to determine medical necessity. Conduct peer-to-peer discussions with providers and ensure compliance with URAC and NCQA guidelines.
Family Medicine-Physician Reviewer-Field Medical Director, Radiology (Full-Time or Part-time)
Evolent
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Full Time
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2 months ago
Evolent
Serve as a physician reviewer for imaging cases to determine medical necessity and conduct peer-to-peer discussions with providers. Ensure compliance with URAC and NCQA guidelines while documenting all clinical communications accurately.
Serve as a physician match reviewer for imaging cases to ensure medical necessity and compliance with URAC and NCQA guidelines. Conduct peer-to-peer discussions with providers to provide clinical rationale for determinations and appeals.
Serve as a physician match reviewer for imaging cases to determine medical necessity and conduct peer-to-peer discussions with providers. Ensure compliance with URAC and NCQA guidelines while providing clinical rationale for appeals.
The Lead HRIS Analyst is responsible for the maintenance, enhancement, and administration of the Workday HCM system. This includes collaborating with stakeholders to automate processes, designing custom reports, and mentoring team members.
The Engineer will manage, support, and optimize contact center technologies including PBX, ACD, IVR, and CTI systems. They will collaborate with cross-functional teams to diagnose technical issues and implement solutions that enhance operational performance and customer experience.
The Medical Director will conduct clinical reviews for oncology cases and engage with oncologists to promote value-based care and evidence-based practices. They will also collaborate with internal teams to design and execute clinical innovation initiatives and ensure compliance with quality standards.
The Lead Analyst will oversee the technical and functional aspects of Workday Financials and Adaptive Insights, including design, configuration, and implementation. They will also mentor junior team members, drive process improvements, and collaborate with cross-functional teams to ensure system quality and performance.
The Senior Analyst will support the performance, optimization, and strategic growth of Musculoskeletal and Radiology Benefits Management programs. Responsibilities include analyzing utilization trends, clinical outcomes, and operational KPIs to drive actionable insights and program enhancements.
The Platform Engineer will design, develop, and maintain Evolent’s Internal Developer Platform built on Backstage using languages like Python or Go, while also automating operational tasks and managing cloud resources primarily in Azure. This role involves leading containerization efforts using Docker and Kubernetes (AKS/ACA) and developing/optimizing CI/CD pipelines in collaboration with engineering teams.
Field Medical Director Internal Medicine/ Emergency Medicine (Cardiology)
Evolent
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Full Time
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4 months ago
Evolent
The Field Medical Director will serve as the specialty-match reviewer for diagnostic cardiology cases that do not initially meet medical necessity guidelines, providing timely, clinically sound medical reviews. This role involves conducting peer-to-peer discussions with requesting physicians and providing evidence-based clinical rationale for standard and expedited appeals.
As a Field Medical Director in Radiology, you will review imaging cases for medical necessity and provide clinical rationale for determinations. You will also collaborate with physicians and assist in the utilization management process.
Field Medical Director, Interventional Cardiology (Remote)
Evolent
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Full Time
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8 months ago
Evolent
The Field Medical Director will provide expert reviews for cardiovascular cases and conduct peer-to-peer discussions with treating providers to ensure high-value care. They will also collaborate with leadership and clinical staff to address complex cases and support decision-making.
As a Field Medical Director in Cardiology, you will review cases that do not meet medical necessity guidelines and provide clinical rationale for appeals. You will also collaborate with physicians and assist in the utilization management process.
