Project Manager, Medical Policy Processes

Evolent partners with health plans and providers to achieve better outcomes for people with the most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of a 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 the 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.

About the role

As a Project Manager on the Medical Policy team, you will work closely with Medical Policy teammates and other key stakeholder business groups to provide exceptional support for the timely and accurate delivery of high-quality Evolent clinical guidelines. Our team values collaboration, continuous learning, ongoing identification of efficiencies and process improvement, and a customer-centric approach, ensuring every team member contributes to providing the best clinical guideline product.

Collaboration Opportunities

The Project Manager will partner most closely with Medical Policy teammates and collaborate with Clinical Operations, Medical Leadership, IT, Provider Relations, and other business groups.

Responsibilities

• Support team responsibilities and project management activities as assigned
• Manage day-to-day operational aspects of Medical Policy team processes
• Support publication of Evolent Clinical Guidelines, Health Plan Specific Guidelines, and Legislative/Regulatory Guidelines
• Maintain source of truth information related to clinical guidelines application for utilization review requests
• Support and maintain information critical to accurate guideline publication
• Prepare reports and/or dashboards to represent project activity and status
• Apply project management methodology and enforce project standards using approved toolkit templates

Requirements

• Bachelor's degree plus 2+ years' project management or job-related experience with a medium to large-scale corporation
• High School or Associate’s degree with a minimum of 5 years of project management or job-related experience within the past 8 years
• Project Management Institute Certification (multiple certification options)
• Lean Six Sigma Black Belt or Green Belt
• Knowledge of project management and process improvement practices and methodologies
• Basic knowledge of health care management (CPT Codes, Medicare/Medicaid)
• Strong facilitation and interpersonal skills with the ability to work effectively with cross-functional teams
• Ability to resolve and/or escalate issues in a timely fashion
• Understand how to communicate difficult/sensitive information tactfully
• Proven ability to plan, organize, schedule, direct, control, and monitor project activities
• Strong working knowledge of Microsoft Product Suite

Technical Requirements

All employees must have the following technical capability at their home: high-speed internet over 10 Mbps. Specifically for call center employees, the ability to plug in directly to the home internet router is required.

Pay

The expected base salary/wage range for this position is $68,000.

Benefits

As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees.