**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:** Our shared services team offers candidates the opportunity to make a meaningful impact by providing exceptional support to internal and external customers through positive interactions, and timely delivery of high-quality products. Our team values collaboration, continuous learning, and a customer-centric approach, ensuring that every team member contributes to providing better health outcomes. Responsible for the development, approval, and maintenance of clinical correspondence to ensure compliance with legislative and accreditation requirements. Act as the clinical liaison to the Compliance Department. **What You Will Be Doing:** + "Develops and customizes correspondence according to regulatory requirements and contractual requirements including coordinating Compliance Department approval for new and existing business. + Provides oversight of the use of appropriate correspondence and review requests for new or modifications to existing correspondence templates. + Clinical liaison to Compliance Department. + Oversees clinical correspondence for all products in collaboration with compliance. + Reviews correspondence and clinical policy submissions under our UR licensure submissions. + Updates clinical correspondence templates as needed to ensure they meet the minimum standards for National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Commission (URAC), Employee Retirement Income Security Act of 1974 (ERISA), Centers for Medicare and Medicaid Services (CMS), and Company Policy across product lines and business segments. + Develop policies for new or existing business, as assigned. + Research state regulatory requirements for clinical correspondence and policies using online technology and research tools. + Develops and implements best practices related to the timely and consistent generation of clinical correspondence. + Consults with IT to support the letter generation process + People Manager as Assigned **Qualifications - Required and Preferred:** + 5+ years of healthcare industry experience. + 3+ years of experience with authorization correspondence, ensuring compliance with state/federal contractual requirements. + Strong interpersonal, consultation, organizational, tracking and follow-up skills. + Ability to research, obtain, coordinate, and integrate feedback and directions from diverse operational groups and organizations into a written product. + Possesses excellent verbal and written communication skills. + Knowledge of legislative/oversight bodies [e.g., National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Commission (URAC), Employee Retirement Income Security Act of 1974 (ERISA), Centers for Medicare and Medicaid Services (CMS)]. + This position requires a solid understanding of NIA's products and workflows in relation to policies and standards. **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. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations. **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** **recruiting@evolent.com** **for further assistance.** The expected base salary/wage range for this position is $. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. 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. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit! For more insights about Evolent Health, click on Life At Evolent (https://www.evolent.com/) to learn more!