Payer Enrollment Operations Manager

🕒 Outubro 22

🚗 Michigan – Remoto

🚗 Michigan – Remote

💵 $90.000 - $110.000 / ano

⏰ Tempo Integral

🟠 Sênior

🔴 Especialista

⚙️ Operações

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Aledade, Inc.

SiteLinkedInTodas as Vagas

501 - 1000 funcionários

Fundada em 2014

🏥 Saúde

⚕️ Seguro de Saúde

🏢 Corporativo

Healthcare • Healthcare Insurance • Enterprise

Aledade, Inc. é uma corporação de benefícios públicos que opera como a maior rede de práticas independentes de cuidados primários nos Estados Unidos. A empresa é especializada em Organizações de Cuidados Responsáveis (ACOs), que ajudam práticas de cuidados primários e centros de saúde a melhorar os resultados dos pacientes e gerar receita sustentável por meio de soluções de cuidados baseados em valor. A Aledade oferece insights de dados, suporte e soluções de negócios para alcançar sustentabilidade e autonomia clínica. Ela colabora com uma ampla gama de provedores de saúde, incluindo práticas de cuidados primários, centros de saúde comunitários e redes de ACOs, garantindo melhoria na qualidade do cuidado e satisfação dos pacientes. Com operações em 45 estados e afiliações com mais de 20. 000 clínicos atendendo mais de 2,5 milhões de pacientes, a Aledade está comprometida em reduzir a fragmentação do cuidado e melhorar a qualidade de vida geral tanto dos clínicos quanto dos pacientes.

Descrição

• Partner with IPA leadership to oversee the administrative engine behind payer contracts, contract membership, payment distribution, and client services delivery • Collaborate across internal departments to help clients maximize pay-for-performance programs, risk sharing arrangements, and value-based contracts • Lead a team that may include an Operations Specialist and Membership Associates • Build respectful, trusting, and productive relationships with internal departments, payers, and client practices • Partner with the Market Manager and IPA Operations Director on strategic initiatives and operational tracking • Monitor payer enrollments, reports, and payments • Lead payment distribution, payment reporting, and tracking • Develop, monitor, and report on KPIs related to IPA operations • Provide care management program oversight, including oversight of third-party care management functions • Mentor, coach, and manage direct reports • Oversee Membership team processes • Respond to customer and prospective customer queries regarding membership, health plan contracts, incentive programs, and IPA information • Coordinate payer meetings for contract administration, updates, and issues, and resolve issues with payers • Conduct internal team meetings covering client strategy, contract deliverables, progress reports, and implementation plans • Oversee delivery of client communication and education materials • Support recruitment efforts with the growth department and IPA Operations Director • Perform other duties as assigned

🎯 Requisitos

• Bachelor’s degree in Business, Healthcare Administration, or related field or equivalent combination of education and experience • 8+ years of experience with a health plan, physician organization, physician office or similar employer in progressively more responsible positions • Strong communication (written and verbal) • Excellent interpersonal skills with ability to interact effectively and credibly at all levels of an organization • Ability to lead, persuade, and influence, particularly as it relates to customer relationship development • Ability to interact effectively with customers and possess a professional business manner • Tact and diplomacy in developing and maintaining positive working relationships • Ability to work and interact with a wide range of associates and leaders internal and external to the organization • Impeccable service ethic characterized by high energy, a positive attitude and the desire to go “the extra mile” for both clients and teammates • Strong analytical and consultative thought process to solve customer problems and generate new business opportunities • Project management skills with ability to prioritize multiple projects, manage and meet multiple deadlines • Superior organization skills to handle multiple simultaneous projects and associated work teams • Familiarity with Microsoft suite • Familiarity with Google suite • Prior management experience preferred • Work involves extended periods of sitting and using a computer screen • Hours may extend beyond the normal workday as needed to serve clients and meet deadlines

🏖️ Benefícios

• 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 • Bonus • Equal opportunity employment

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