Senior Director, Delegate Oversight

🕒 Maio 1

🏄 California – Remoto

🏄 California – Remote

💵 $130.332 - $195.498 / ano

⏰ Tempo Integral

🟠 Sênior

👔 Diretor

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Alignment Health

SiteLinkedInTodas as Vagas

501 - 1000 funcionários

Fundada em 2013

⚕️ Seguro de Saúde

💰 $135.000.000 Series C em 2020-03

Healthcare Insurance • Insurance • Healthcare

Alignment Health está comprometida em fornecer cuidados abrangentes para membros do Medicare, enfatizando as necessidades dos idosos, dos cronicamente doentes e daqueles que são frágeis. Com a missão de transformar a saúde dos idosos, a Alignment Health utiliza um modelo de atenção personalizado e tecnologia avançada para oferecer serviços de saúde de alta qualidade e baixo custo. Sua equipe de atendimento de concierge 24 horas por dia, 7 dias por semana, colabora com provedores locais confiáveis para garantir que cada membro receba um atendimento personalizado, refletindo o compromisso da empresa em tratar todos os membros como membros valiosos da família.

Descrição

• Own and evolve the enterprise delegated oversight strategy, ensuring alignment with corporate objectives, regulatory requirements, and value-based care priorities. • Establish a holistic performance framework that integrates clinical, operational, financial, and compliance metrics across all delegated entities. • Maintain accountability for delegated performance outcomes, including quality, utilization, risk adjustment, member experience, and cost of care. • Ensure oversight models are scalable and adaptable to support organizational growth and increasing complexity in risk-bearing arrangements. • Define and lead enterprise governance structures that proactively identify, assess, and mitigate risks across the delegated network. • Oversee risk stratification methodologies, performance scoring, and audit frameworks to ensure consistency, rigor, and regulatory alignment. • Act as the senior escalation point for performance and compliance risks, ensuring timely intervention and resolution of issues with enterprise impact. • Provide regular, transparent reporting to executive leadership on delegated performance, risks, and mitigation strategies. • Serve as the lead relationship owner for delegated partner executives, driving alignment on performance expectations and long-term strategy. • Facilitate executive-level performance reviews with IPAs and MSOs, ensuring accountability and measurable improvement. • Influence internal executive stakeholders by translating performance insights into strategic recommendations and action plans. • Represent delegated oversight in enterprise initiatives, regulatory readiness efforts, and cross-functional planning. • Drive the evolution of delegated oversight into a proactive, insight-driven function, leveraging analytics to identify opportunities and intervene early. • Lead cross-functional collaboration with Clinical, Quality, Compliance, Network, and Operations teams to improve delegated outcomes. • Promote standardization, best practice sharing, and continuous improvement across the delegated network. • Ensure tools, reporting, and processes enable effective performance management and decision-making. • Lead and develop a high-performing team, setting clear expectations and fostering a culture of accountability and continuous improvement.

🎯 Requisitos

• 10–12+ years of experience in healthcare operations, delegated oversight, provider network management, or value-based care. • 5+ years of leadership with delegation oversight specifically, compliance or provider performance • 5+ years of leadership experience with accountability for performance outcomes. • Experience developing and executing performance management strategies across clinical, operational, and compliance domains. • Demonstrated ability to influence senior stakeholders and manage external partner relationships. • Strong understanding of healthcare regulatory frameworks (CMS, DMHC, DHCS, NCQA) and delegated models. • Experience working in matrixed organizations and driving cross-functional initiatives. • Bachelor's degree required in Healthcare Administration, Public Health, Business Administration, Nursing, or a related field. • Master’s degree strongly preferred (e.g., MHA, MPH, MBA, MSN) with a focus in healthcare management, policy, or operations.

🏖️ Benefícios

• Health insurance • Competitive salary • 401(k) • Paid time off • Flexible work arrangements