What are the responsibilities and job description for the Healthcare Administrator position at Evlo AI?
About The Role
The Healthcare Administrator owns operational workflows that support healthcare delivery, patient access, provider administration, billing coordination, and regulatory compliance across the US healthcare system. The role uses healthcare information systems, reporting tools, and documented controls to keep administrative operations accurate, efficient, and audit-ready.
Working remotely from Denver, the role partners with clinical, finance, compliance, product, and customer operations teams to resolve process gaps and improve how healthcare programs are delivered. Success means fewer administrative errors, faster issue resolution, stronger documentation, and reliable adherence to HIPAA and applicable federal and state requirements.
Key Responsibilities
The Healthcare Administrator owns operational workflows that support healthcare delivery, patient access, provider administration, billing coordination, and regulatory compliance across the US healthcare system. The role uses healthcare information systems, reporting tools, and documented controls to keep administrative operations accurate, efficient, and audit-ready.
Working remotely from Denver, the role partners with clinical, finance, compliance, product, and customer operations teams to resolve process gaps and improve how healthcare programs are delivered. Success means fewer administrative errors, faster issue resolution, stronger documentation, and reliable adherence to HIPAA and applicable federal and state requirements.
Key Responsibilities
- Manage day-to-day administrative workflows across patient intake, scheduling, referrals, eligibility verification, claims coordination, and provider operations
- Configure and maintain healthcare administration systems, CRM workflows, ticketing queues, and shared documentation in tools such as Salesforce, Zendesk, and Confluence
- Monitor operational KPIs including turnaround time, denial rates, authorization status, service-level attainment, and data-quality exceptions
- Coordinate audits, compliance reviews, and corrective action plans related to HIPAA, CMS requirements, payer policies, and internal controls
- Document standard operating procedures, process maps, escalation paths, and training materials for distributed operations teams
- Investigate operational issues using spreadsheets, SQL-based reporting, or BI dashboards and implement improvements that reduce rework and administrative risk
- Lead cross-functional projects involving system launches, workflow changes, vendor integrations, and regulatory updates from requirements through adoption
- 3-8 years of experience in healthcare administration, healthcare operations, practice management, payer operations, or a related field
- Working knowledge of US healthcare processes, including HIPAA, patient privacy, eligibility, prior authorization, referrals, claims, and payer-provider workflows
- Hands-on experience with healthcare information systems, CRM or case-management platforms, ticketing tools, and operational reporting
- Strong analytical skills with proficiency in Excel or Google Sheets; experience with SQL, Tableau, Looker, or similar BI tools preferred
- Demonstrated ability to manage cross-functional projects, create SOPs, track risks, and deliver process improvements in regulated environments
- Bachelor’s degree in healthcare administration, business, public health, or a related discipline; equivalent professional experience may be considered
- Bonus: Experience with EHR or practice-management systems, CMS or NCQA requirements, healthcare interoperability standards such as HL7/FHIR, and certifications such as CHC, CPHQ, or CMPE