Position summary

Evolent Health is looking for a Data Analyst of Health Care to be a key member of the technology leadership team. This individual will play a critical role in executing Evolent Health’s mission by managing data-driven activities related to data profiling, data discovery and analysis, requirements definition, testing and continuous improvement of data collection, mapping, analysis and transformation processes. 

Essential functions

• Analyze data files, data layouts and data dictionaries from providers of health care administrative data (eligibility, account/plan, medical claims, pharmacy claims) to understand data structure and operating rules for transforming to common data format


• Conduct in-depth interviews with data providers (client or payer staff) to ensure comprehensive understanding of data operating logic and data provided


• Author data mapping and transformation requirements based on understanding of operating rules; review with ETL developers to ensure understanding


• Produce detailed data quality profiles from client health care administrative data to validate structure, content and overall data quality; present findings to internal stakeholders for signoff and/or escalate critical data issues as necessary


• Serve as subject matter expert in primary data domain relative to client’s data and transformation rules; back up analysts in other data domains as workloads and priorities necessitate


• Execute test cases to validate source data has been accurately mapped, transformed and loaded to common format


• Collaborate with data warehouse QA team to ensure seamless execution of test cases end-to-end


• Alert project managers to potential risks and issues of importance

Academic Qualification

• 5+ years of experience in information technology


• Bachelor's Degree required


• SQL skills to write queries, join tables to view/test data in a relational database

• Understanding of Medical Claims, Rx Claims, Eligibility/Membership, healthcare insurance benefit and group account setup, Provider data and related processes around them

Preferred

• SAS skills for querying datasets


• A knack for dealing with healthcare datasets and finding relationships in the data and any gaps/issues


• Patience and persistence to sift through complex data/information to get to the core knowledge


• Experience with clinical coding systems: ICD9 diagnosis codes, ICD9 procedure codes, CPT codes, revenue codes, provider NPI codes, NDC Rx codes.


• Knowledge of medical claim file contents (both UB04 and HCFA-1500) and significance of individual fields


• Experience in analyzing, defining and documenting business processes and rules


• Experience testing data and creating related test cases


• Proven track record in establishing strong relationships with internal stakeholders, clients and vendors


• Intense intellectual curiosity and an ability to view problems with a fresh perspective


• Excellent written computer and oral communication skills