Note: The job is a remote job and is open to candidates in USA. Aledade is seeking a Senior Health Plan Performance Operations Analyst to transform complex health plan data into strategic insights that improve value-based care contract performance. The role focuses on dashboard development, data analysis, quality assurance auditing, operational data management, and mentoring and coordination across teams.
Responsibilities
- Design, build and maintain dashboards, productivity trackers, and KPIs utilized by leadership to improve market performance and daily operations
- Build high-complexity queries of back-end data to power dashboards and custom ad-hoc projects
- Present data findings clearly through visualization tools to ensure understanding among diverse stakeholders and colleagues
- Incorporate industry benchmarks into visual metrics (charts, graphs, pivot tables) to show baseline and current states
- Identify, monitor, and communicate changes or trends in quality and spend metrics
- Act as the first line of defense investigating, triaging, documenting, and resolving internal and external data quality issues
- Create and apply testing algorithms to evaluate large data streams throughout the system data flow
- Audit year-end performance and claims data for discrepancies, reporting errors to payer teams for swift resolution
- Source, clean, and organize data from multiple streams (payer portals, Rx claims files, SFTP sites, and internal databases)
- Execute advanced SQL queries in Snowflake to supplement payer data for analysis and reporting QA
- Develop complex formulas and templates in Google Sheets and Excel to streamline repetitive data tasks
- Maintain comprehensive documentation regarding operational analytics, source-of-truth architectures, and peer cross-coverage plans
- Assist the manager with work coordination, mentoring junior analysts, developing training plans, and reviewing team work products
- Serve as a data subject matter expert (SME); attend meetings in the manager's absence
- Facilitate clear intradepartmental and cross-functional communication among key stakeholders
- Other duties as assigned
Skills
- Bachelor's degree in a related quantitative field or equivalent professional experience
- 4+ years of experience with data management, analysis, QA, and auditing healthcare or payer data
- Intermediate SQL programming experience (Snowflake preferred)
- Advanced Microsoft Excel / Google Sheets skills (complex formulas, nested functions, pivot tables)
- Strong communication skills with the ability to collaborate effectively across remote teams
- Proactive mindset with a proven ability to prioritize multiple tasks in a fast-paced environment
- Prolonged periods of sitting at a desk and working on a computer
- Understanding of value-based care/Alternative Payment Models, Medicare, and Non-MSSP quality measures
- Experience with statistical software, such as R or Stata
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