Operating Effectiveness Senior Analyst - EviCore

Jobgether SRL; United States; Remote; USD 63,000 - 106,000; Full time

Benefits offered by this job

Annual bonus plan

Medical, vision & dental benefits

401(k) plan

Company-paid life insurance

Tuition reimbursement

Paid time off (18+ days)

Remote work environment

Job summary

Jobgether SRL, listed as a partner company, seeks an Operating Effectiveness Senior Analyst - EviCore based in the United States. The role links clinical operations, business rules, and technology to scale complex healthcare programs through automated decision-support and AI-enabled workflows.

You will design workflows, translate requirements into logic, collaborate across teams, and ensure compliance with HIPAA and related standards while pursuing continuous process improvement.

Qualifications

• Bachelor's degree or equivalent in a related field.
• Experience in healthcare operations, decision support, or process improvement.
• Ability to translate requirements into workflows and system configurations.
• Familiarity with analytic tools and data platforms is preferred.

Responsibilities

• Design, develop, and optimize decision-support pathways and automated workflows.
• Translate guidelines and client needs into system logic and configurations.
• Collaborate with Clinical, Operations, Product, Technology, Data, and Business teams.
• Identify opportunities for automation and AI integration.
• Apply data analysis and root-cause analysis to improve outcomes.
• Develop scalable solutions for clinical decision-making and user experience.
• Perform functional, regression, and quality assurance testing.
• Monitor performance and collect user feedback for improvements.
• Create process documentation, SOPs, and governance controls.
• Support new program implementations and change management.

Skills

Analytical thinking

Communication

Stakeholder management

Education

Bachelor's degree or equivalent

Tools

Visio

SharePoint

Tableau

SQL

Databricks

Job description

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Operating Effectiveness Senior Analyst - EviCore based in United States.

This role connects clinical operations, business processes, technology, and decision-support systems to improve how complex healthcare programs operate at scale. You’ll design and optimize clinical and operational workflows, business rules, algorithms, and automated decision-support solutions. The position offers an opportunity to translate clinical and business requirements into practical system logic and AI-enabled workflows. Your work will directly support decision quality, operational efficiency, compliance, and user experience. You’ll collaborate closely with clinical, operational, product, technology, data, and business stakeholders. The environment combines analytical problem-solving, process innovation, automation, and continuous improvement.

• Design, develop, maintain, and optimize clinical decision-support pathways, business rules, algorithms, and automated workflows that deliver consistent, accurate, and scalable operational outcomes.
• Translate clinical guidelines, business requirements, regulatory standards, and client needs into system logic, workflow configurations, pathways, and decision-support solutions.
• Partner with Clinical, Operations, Product, Technology, Data, and Business teams to identify opportunities for automation, AI integration, workflow simplification, and improved operational effectiveness.
• Apply data analysis, critical thinking, and root cause analysis to resolve operational challenges, improve outcomes, and support continuous process improvement initiatives.
• Develop scalable solutions that enhance clinical decision-making, automated rationale generation, letter production, utilization management operations, and overall user experience.
• Conduct functional, regression, and quality assurance testing to verify the accuracy, compliance, performance, and reliability of implemented solutions.
• Monitor system performance, operational metrics, and user feedback to identify enhancement opportunities and optimize decision-support workflows.
• Create and maintain process documentation, standard operating procedures, workflow diagrams, training materials, and governance controls.
• Support new program implementations, enhancements, and enterprise initiatives through testing, training, deployment, and change management activities.
• Ensure solutions align with applicable regulatory, accreditation, compliance, privacy, and quality standards, including HIPAA, NCQA, and URAC requirements.
• Use reporting, analytics, and emerging AI technologies to generate insights, improve decision accuracy, reduce manual effort, and increase operational scalability.

Requirements:

• Bachelor’s degree in Science, Healthcare Administration, Computer Science, Data Analytics, Mathematics, Information Systems, or a related field, or equivalent professional experience.
• Experience in healthcare operations, utilization management, clinical decision support, product operations, process improvement, or business systems analysis.
• Strong analytical and problem-solving abilities, with excellent communication and stakeholder management skills.
• Demonstrated ability to translate business requirements into workflows, decision logic, pathways, algorithms, or system configurations.
• Familiarity with workflow design tools, business rules engines, Visio, SharePoint, Tableau, SQL, Databricks, or comparable analytics and process automation technologies is preferred.
• Experience supporting AI-enabled solutions, automation initiatives, intelligent workflow platforms, or decision-support technologies is preferred.
• Ability to balance hands‑on operational execution with strategic thinking, innovation, and continuous improvement.
• For remote work, a cable broadband or fiber optic internet connection with minimum speeds of 10 Mbps download and 5 Mbps upload is required.

Benefits:

• Annual salary of $63,400–$105,600 USD, depending on relevant factors including experience and geographic location.
• Eligibility to participate in an annual bonus plan.
• Medical, vision, and dental benefits starting on day one.
• Well‑being and behavioral health programs.
• 401(k) plan.
• Company‑paid life insurance.
• Tuition reimbursement.
• Minimum of 18 days of paid time off per year.
• Paid holidays and leaves of absence.
• Remote work environment.