Job Description
Your Future Evolves Here
Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.
Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.
Join Evolent for the mission. Stay for the culture.
What You’ll Be Doing:
JobSummary
We are seeking a passionate, motivated APP mentor/ leader to join our team. The ideal candidate will have a strong understanding of Medical Oncology and the utilization review process in addition to strong leadership acumen.
Collaboration Opportunities:
This position is responsible for the management, direct supervision, and coordination of clinicalstaff performing utilization management reviews, providing expertise in Medical Oncology.
Essential Functions
· Assists in clinical leadership in the development and on-going management of designated staff.
· Performs care management review activities consistent with Evolent policies, procedures, and standards.
· Conducts recruitment, interviewing, and selection of properly qualified staff members and ensures appropriate orientation is provided.
· Regularly monitors the performance of utilization management staff. Monitors adherence to the efficiency goals for all staff including case volume, case closure rates, average handle time and other metrics.
· Supervises utilization management staff through approved audit processes including performing annual reviews and provides counseling and disciplinary action as necessary.
· Coordinates quality improvement activities under the direction of clinical management.
· Assists management in the development of strategic and operational goals and plans.
· Assists management in the identification and coordination of the necessary clinical and client service training needs.
· Analyzes specific utilization problems, plans and implements solutions that directly influence quality of care and cost efficiency.
· Supervises the collection of pertinent clinical information while maintaining a good rapport and relationship with providers.
· Performs other duties as assigned.
Required Qualifications
- Active and unrestricted APP licensure required (nurse practitioner or physician assistant)
- 3+ years clinical experience in medical oncology required
- 2+ year(s) supervisory experience Strongly Preferred
- Knowledge of healthcare industry and Utilization Management (UM)
- Exceptional communication, presentation, organizational and interpersonal skills
- Strong working knowledge of MS Office Suite and ability to quickly learn new software applications
- Availability to work 40 hours a week, during normal business hours (Monday-Friday)
Preferred Qualifications
- 1+ year(s) Utilization Management experience
- Understanding of various lines of business, including pharmacy benefits and medical benefits
To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration.
Technical Requirements:
We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router.
Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.If you need reasonable accommodation to access the information provided on this website, please contact for further assistance.
The expected base salary/wage range for this position is $160,000-$174,000. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.Originally posted on Himalayas
