Health Plan Performance Specialist
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Job Location:
Atlanta, GA - USA
Monthly Salary:
Not Disclosed
Posted on:
2 days ago
Vacancies:
1 Vacancy
Job Summary
The Health Plan Performance (HPP) Specialist serves as a critical strategic partner and primary liaison between Aledade and our payer partners. This role is responsible for the end-to-end orchestration of health plan performance strategies ensuring that our Medicare Advantage Commercial and Medicaid contracts are meeting and exceeding financial and clinical benchmarks. Beyond mere oversight the Specialist acts as a bridge between high-level payer data and on-the-ground execution translating complex analytics into actionable market strategies that drive shared savings improve quality scores and lower the total cost of care. As a subject matter expert you will navigate a high-visibility environment collaborating with cross-functional leadership and market field teams to solve complex operational challenges and solidify Aledades position as a leader in value-based care.
Primary Duties
- Establish goals and track key performance indicators (KPIs) related to health service utilization cost of care quality measure performance and shared savings for health plan payer contracts (Medicare Advantage Commercial and Medicaid)
- Educate market field teams on payer-specific quality programs and incentives
- Lead internal and external stakeholder engagements on behalf of HPP Managers and Directors as needed
- Serves as a subject matter expert for the HPP Analysts; Train and onboard new HPP analysts on payer strategy and internal Aledade tools
- Collaborate with cross-functional stakeholders (Affordability Quality and Risk) to develop and deploy market-level performance strategies around quality utilization and cost improvements
- Facilitate effective communication amongst internal and external key stakeholders regarding data strategy and operational initiatives
- Analyze payer data to identify trends and strategic opportunities within key payer contracts.
- Synthesize internal and external reporting data into actionable performance strategies
- Articulate analytical requests to analytics teams as needed
Minimum Qualifications
- Bachelors degree in Health Administration Public Health Business or related field
- 3 yrs experience working with Health Plans and performance analytics
- Strong knowledge of Medicare Advantage Commercial and Medicaid performance; Knowledge of HEDIS measures and STARs performance
- Proficient in Google Sheets or Excel as a data management tool
- Strong analytical skills and attention to detail
- Excellent communication (Written & Verbal) presentation and interpersonal skills; Ability to work will various levels of stakeholders
- Strong strategic thinking and problem-solving skills
- Strong organizational skills; Ability to manage multiple projects and deliver results
Preferred Qualifications
- Experience in value based care
- Experience using Tableau or other data management software
Physical Requirements
- Prolonged periods of sitting at a desk and working on a computer
Who We Are:
Aledade a public benefit corporation exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014 and since then weve become the largest network of independent primary care in the country - helping practices health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally by creating value-based contracts across a wide variety of health plans we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients good for practices and good for society - and if youre eager to join a collaborative inclusive and remote-first culture - youve come to the right place.
What Does This Mean for You
At Aledade you will be part of a creative culture that is driven by a passion for tackling complex issues with respect open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences interests backgrounds beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.
In addition to time off to support work-life balance and enjoyment we offer the following comprehensive benefits package designed for the overall well-being of our team members:
Flexible work schedules and the ability to work remotely are available for many roles
Health dental and vision insurance paid up to 80% for employees dependents and domestic partners
Robust time-off plan (21 days of PTO in your first year)
Two paid volunteer days and 11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program and Clinical Employee Reimbursement Program
401(k) with up to 4% match
Stock options
And much more!
At Aledade we dont just accept differences we celebrate them! We strive to attract develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit qualifications performance and business needs. All qualified candidates will receive consideration for employment without regard to age race color national origin gender (including pregnancy childbirth or medical conditions related to pregnancy or childbirth) gender identity or expression religion physical or mental disability medical condition legally protected genetic information marital status veteran status or sexual orientation.
Privacy Policy:By applying for this job you agree to AledadesApplicant Privacy Policy available at may use automated tools including artificial intelligence (AI) to help organize and evaluate application materials. These tools support our recruiters and hiring managers by helping manage large applicant pools. Human judgment plays an essential role in our hiring process including in the oversight and use of any automated tools. If you would like more information about our screening and hiring process please contact us.
Required Experience:
IC
Key Skills
- Accounts Handling
- Access
- Commissioning
- Biotechnology
- Civil Engineering
- Health And Safety Management
About Company
Aledade works with independent practices, health centers, and clinics to build and lead Accountable Care Organizations (ACOs) anchored in primary care.
