Manager, Delegate Performance

🕒 March 27

Apply Now

Find Similar Remote Jobs

Receive Emails For Remote Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Alignment Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

👥 B2C

💰 $321.1M Post-IPO Debt - Alignment Health on 2024-11

Healthcare Insurance • B2C

Alignment Health is a Medicare-focused health insurance company that offers Medicare Advantage plans and member-centered services. It provides 24/7 on-demand access to care via in-person, in-home, and mobile channels and features a concierge-style on-demand card to help members schedule appointments, arrange transportation, and answer health questions. Alignment Health partners with brokers, providers, Accountable Care Organizations (ACOs), and institutional partners, operates in multiple U. S. states (including Arizona, California, Nevada, North Carolina, and Texas), and has earned high CMS ratings and industry recognition.

📋 Description

• Own the end-to-end performance management process for assigned delegated entities, synthesizing audit results, monitoring outputs, scorecards, and operational data into a comprehensive view of delegate performance. • Translate compliance and operational findings into actionable performance insights, clearly articulating root causes, risk implications, and improvement opportunities across claims, UM, CM/CCM, appeals, and credentialing. • Conduct ongoing trend analysis to identify emerging performance risks, patterns, or improvement opportunities beyond discrete audit cycles. • Develop and maintain delegate-specific performance profiles that integrate clinical, operational, and compliance dimensions. • Lead routine and ad hoc performance discussions with delegated partners, ensuring clear communication of expectations, performance gaps, and progress against improvement plans. • Partner with delegates to define performance improvement actions, milestones, and success measures informed by audit and monitoring outputs. • Monitor delegate progress against agreed-upon action plans, escalating sustained or systemic performance concerns to the Director of Delegate Oversight as appropriate. • Prepare clear, concise performance summaries and presentations for leadership, translating complex data into actionable insights. • Support enterprise initiatives related to delegated performance, including regulatory readiness, value-based care objectives, and clinical quality improvement efforts.

🎯 Requirements

• 6+ years of experience in healthcare operations, delegated oversight, provider performance management, or value-based care environments. • 3+ years of experience in a performance management, oversight, analytics, or operational leadership role within a health plan, IPA, MSO, or related organization. • Demonstrated experience interpreting audit results, monitoring outputs, or regulatory findings and translating them into operational or performance improvement actions. • Strong understanding of delegated functions including claims, UM, CM/CCM, appeals, and credentialing. • Proven ability to engage provider organizations or delegated partners in structured performance discussions. • Experience working cross-functionally in matrixed healthcare organizations. • Bachelor’s degree required in Healthcare Administration, Public Health, Business Administration, Nursing, or a related field. • Master’s degree preferred (e.g., MHA, MPH, MBA, MSN).

🏖️ Benefits

• Health insurance • Retirement plans • Flexible work arrangements • Professional development