Manager, Compliance – Delegate Oversight, Reporting, Analytics

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Alignment Health

SiteLinkedInTodas as Vagas

501 - 1000 funcionários

Fundada em 2013

⚕️ Seguro de Saúde

👥 B2C

💰 $321.050.000 Post-IPO Debt - Alignment Health em 2024-11

Healthcare Insurance • B2C

A Alignment Health é uma empresa de seguros de saúde focada no Medicare, que oferece planos Medicare Advantage e serviços centrados nos membros. Ela oferece acesso a cuidados 24 horas por dia, 7 dias por semana, por meio de canais presenciais, domiciliares e móveis, e dispõe de um cartão sob demanda no estilo concierge para ajudar os membros a agendar consultas, organizar transporte e responder a perguntas de saúde. A Alignment Health faz parcerias com corretores, prestadores de serviços, Organizações de Cuidados Responsáveis (ACOs) e parceiros institucionais, opera em vários estados dos EUA (incluindo Arizona, Califórnia, Nevada, Carolina do Norte e Texas), e recebeu altas classificações do CMS e reconhecimento no setor.

Descrição

• Own the analytics, reporting, and performance monitoring framework for both internal operations and delegated entities to support regulatory compliance and oversight requirements. • Serve as a hands-on contributor in developing reports, dashboards, and analytics — including writing queries, building visualizations, and synthesizing insights for performance improvement. • Lead the development and maintenance of dashboards and scorecards that measure delegate performance, contractual compliance, corrective action progress, and operational risk indicators. • Partner with Compliance, Delegation Oversight, and Operations teams to define expectations, metrics, and escalation criteria for delegate monitoring. • Conduct root cause analysis and trend evaluations on compliance issues, audit findings, or delegate performance gaps, providing data-backed recommendations for corrective action. • Translate regulatory, contractual, and audit requirements into measurable analytic and reporting structures. • Prepare and validate data and reports to support CMS, state, or internal audits and readiness reviews, including universe build development and reconciliation. • Serve as a subject matter expert on compliance reporting definitions, data structures, and methodologies. • Lead, develop, and manage a team of analysts — assigning work, reviewing deliverables, coaching skill development, and building analytical rigor. • Work with BI, Data Engineering, and IT teams to improve data access, reporting automation, and governance of compliance data sources. • Present findings and risks to leadership and cross-functional stakeholders with clear storytelling and recommended actions.

🎯 Requisitos

• 5+ years of experience in healthcare analytics, compliance reporting, regulatory oversight, or delegated entity monitoring. • 2+ years of experience leading analysts or project teams, preferably in a working manager or hybrid leadership role. • Demonstrated experience producing reporting and insights in regulated environments (Medicare Advantage preferred). • Bachelor's degree in Data Analytics, Business, Public Health, Information Systems, Healthcare Administration, or a related field. • SQL and/or BI tools (Power BI, Tableau, etc.) proficiency • Ability to translate regulatory and contractual requirements into measurable KPIs and reporting structures. • Strong analytical and critical-thinking skills.

🏖️ Benefícios

• Health insurance • Performance bonuses • Paid time off • Professional development opportunities