Manager, Compliance – Delegate Oversight, Reporting, Analytics

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Alignment Health

WebsiteLinkedInAlle Stellen

501 - 1000 Mitarbeiter

Gegründet 2013

⚕️ Krankenversicherung

👥 B2C

💰 €321.050.000 Post-IPO Debt - Alignment Health im 2024-11

Healthcare Insurance • B2C

Alignment Health ist ein auf Medicare fokussiertes Krankenversicherungsunternehmen, das Medicare Advantage-Pläne und mitgliederzentrierte Dienstleistungen anbietet. Es bietet rund um die Uhr an sieben Tagen der Woche Zugang zu Pflegeleistungen über persönliche, häusliche und mobile Kanäle und bietet eine Concierge-Karte auf Abruf, die Mitgliedern hilft, Termine zu vereinbaren, Transportmittel zu organisieren und Gesundheitsfragen zu beantworten. Alignment Health arbeitet mit Vermittlern, Anbietern, Accountable Care Organizations (ACOs) und institutionellen Partnern zusammen, ist in mehreren US-Bundesstaaten tätig (darunter Arizona, Kalifornien, Nevada, North Carolina und Texas) und hat hohe CMS-Bewertungen und Anerkennung in der Branche erhalten.

Beschreibung

• 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.

🎯 Anforderungen

• 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.

🏖️ Vorteile

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