Senior Director, Delegate Oversight

🕒 vor 1 Monat

🏄 California – Remote

🏄 California – Remote

💵 $130.332 - $195.498 / Jahr

⏰ Vollzeit

🟠 Senior

👔 Direktor

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Alignment Health

WebsiteLinkedInAlle Stellen

501 - 1000 Mitarbeiter

Gegründet 2013

⚕️ Krankenversicherung

💰 €135.000.000 Series C im 2020-03

Healthcare Insurance • Insurance • Healthcare

Alignment Health engagiert sich für die Bereitstellung umfassender Pflege für Medicare-Mitglieder, wobei der Fokus auf den Bedürfnissen von Senioren, chronisch Kranken und gebrechlichen Personen liegt. Mit der Mission, das Gesundheitswesen für Senioren zu transformieren, nutzt Alignment Health ein maßgeschneidertes Pflegemodell und fortschrittliche Technologie, um qualitativ hochwertige, kostengünstige Gesundheitsdienstleistungen anzubieten. Ihr 24/7-Konzierge-Pflegeteam arbeitet mit vertrauenswürdigen lokalen Anbietern zusammen, um sicherzustellen, dass jedes Mitglied eine individuelle Betreuung erhält, was das Engagement des Unternehmens widerspiegelt, alle Mitglieder als geschätzte Familienmitglieder zu behandeln.

Beschreibung

• 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.

🎯 Anforderungen

• 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.

🏖️ Vorteile

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