Analyst, Provider Data Management (Credentialing)

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Join Our Mission at Evolent Health: Analyst, Provider Data Management (Credentialing) Opportunity

Your future evolves here! At Evolent Health, our bold mission is to transform the health of the nation by revolutionizing healthcare delivery. Driven by this mission, we come to work energized every day, embracing innovation, challenging the status quo, and learning from setbacks. We celebrate both our individual abilities and our team successes, fostering a workplace where you can thrive both personally and professionally.

Why Evolent Health?

We are on a rapid growth trajectory, increasing our global workforce by nearly 50% in 2021, with continued expansion through 2022. Evolent Health is not only a career but a supportive place to grow, recognized both in India and the U.S. for our workplace culture and commitment to diversity and inclusion. Highlights of our accolades include:

  • Great Places to Work certification in Pune, India (2021)
  • Named on the Best Company for Women to Advance list by Parity.org (2020 & 2021)
  • A perfect score on the Human Rights Campaign's Corporate Equality Index for LGBTQ+ workplace equality

We value employees who live our core values, contribute to our community, and bring authenticity to work every day. Join a team that is mission-driven and backed by a company that supports your personal and professional journey.

Job Role: Analyst, Provider Data Management (Credentialing)

As an Analyst in Credentialing Operations, you will play a pivotal role in maintaining provider data integrity and compliance. This dynamic position reports to the Associate Director of Credentialing Operations and involves:

  • Determining provider types requiring credentialing
  • Initiating and managing the Primary Source Verification Process
  • Performing provider outreach and administrative auditing.
  • Maintaining adherence to NCQA credentialing guidelines along with partner-specific policies.
  • Monthly monitoring of exclusions, sanctions, and adverse events.
  • Representing the Credentialing department in various meetings and managing special projects.

Collaboration and Team Interaction

You will closely collaborate with the Provider Data Management team using our Jira ticketing system for efficient workflow and cross-departmental engagement.

What We Need From You:

Required Qualifications:

  • Bachelor’s Degree or equivalent work experience
  • Strong verbal and written communication skills
  • Detail-oriented and organized
  • Ability to adapt to agile and fluctuating work situations
  • Proficiency in Microsoft Office Suite

Preferred Experience:

  • 2-3 years in healthcare-related fields like credentialing, provider services, or similar areas
  • Knowledge of US healthcare systems, Managed Care Organizations, Medicare and Medicaid

Technical Requirements for Remote Work:

  • High-speed internet over 10 Mbps
  • Capability to connect directly to your home internet router

Evolent Health is committed to equality of opportunity for all applicants. We make hiring decisions without regard to race, color, religion, gender, sexual orientation, national origin, veteran status, or disability.

Ready to change healthcare? Apply now to become part of our mission-driven team at Evolent Health as an Analyst in Provider Data Management (Credentialing) and help us revolutionize healthcare delivery.