Design and develop scalable backend services and data ingestion pipelines using Python and Azure services. Collaborate in an Agile environment to build healthcare-focused software solutions and optimize legacy SQL systems.
Evolent
44 Remote Job Openings at Evolent
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.
The role involves managing and executing Sarbanes-Oxley (SOX) 404 compliance efforts, including testing key controls and documenting audit workpapers. The candidate will identify process improvements and collaborate with process owners to remediate internal control deficiencies.
The Analyst provides client-specific insights and data-driven recommendations to support health plan operations and strategic decision-making. Responsibilities include managing reporting, analyzing utilization trends, and presenting findings to internal and external stakeholders.
The role focuses on managing strategic client relationships to drive growth, retention, and satisfaction within the healthcare sector. Key duties include developing presentation strategies for senior stakeholders and collaborating cross-functionally to resolve client issues.
Lead the strategy and execution of scalable provider data pipeline solutions to enable seamless client implementations. Manage the product backlog and collaborate with agile teams to align technical delivery with business needs.
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.
The Platform Engineer will manage cloud infrastructure and develop internal platform solutions to enhance application reliability. Key duties include automating infrastructure via IaC and designing CI/CD pipelines for secure deployments.
The Clinical Reviewer ensures appropriate utilization of services by reviewing provider requests for medical necessity and supporting documentation. They authorize services based on approved clinical guidelines and collaborate with medical directors and leadership to ensure cost-effective care.
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.
Design and develop BI reporting platforms and user-facing data visualization tools such as Power BI dashboards and SSRS reports. Perform complex data analysis and collaborate with non-technical stakeholders to gather requirements for business analytics solutions.
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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20 days 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 the monthly revenue cycle close and supervise a team of accountants to ensure GAAP compliance. Manage revenue-related GL accounts, SEC disclosures, and collaborate with internal and external auditors.
Design and deploy AI-enabled analytics workflows by building data pipelines in Microsoft Fabric and engineering prompts for Azure OpenAI. Develop automation scripts for reporting and compliance while maintaining self-service analytics infrastructure.
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.
Manage day-to-day software engineering activities and provide technical guidance to team members. Oversee the design, development, and deployment of scalable software solutions while collaborating with stakeholders on technical roadmaps.
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.
The Coordinator processes prior authorization requests and manages data entry into proprietary systems for medical and behavioral health reviewers. They collaborate with physician offices to obtain missing information and resolve technical barriers via IT tickets.
The Coordinator processes prior authorization requests and manages data entry into proprietary systems for medical and behavioral health reviewers. They collaborate with physician offices to obtain missing information and resolve technical barriers via IT tickets.
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 Platform Network Engineer will design, implement, and manage a secure, scalable Azure-driven cloud networking environment. They will also serve as a Subject Matter Expert, collaborating with engineering and infosec teams to drive network architecture strategy and automation.
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.
The VP of Cardiovascular Medicine will lead cardiology and vascular-related utilization management and clinical operations. This role involves ensuring high-quality adjudication of cardiology decisions and serving as a strategic liaison between clinical teams and clients.
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.
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.
Field Medical Director, Interventional Cardiology (Remote)
Evolent
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Full Time
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7 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.
