Senior Health Plan Operations Analyst

🕒 October 21

🇺🇸 United States – Remote

💵 $66k - $79k / year

⏰ Full Time

🟠 Senior

⚙️ Operations

👻 Ghost score 0%

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Aledade, Inc.

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2014

🏥 Healthcare

⚕️ Healthcare Insurance

🏢 Enterprise

Healthcare • Healthcare Insurance • Enterprise

Aledade, Inc. is a public benefit corporation that operates as the largest network of independent primary care practices in the United States. The company specializes in Accountable Care Organizations (ACOs), which help primary care practices and health centers improve patient outcomes and generate sustainable revenue through value-based care solutions. Aledade offers data insights, support, and business solutions to achieve sustainability and clinical autonomy. It collaborates with a wide range of healthcare providers, including primary care practices, community health centers, and network ACOs, ensuring improved quality of care and patient satisfaction. With operations in 45 states and affiliations with over 20,000 clinicians serving more than 2. 5 million patients, Aledade is committed to reducing care fragmentation and enhancing the overall quality of life for clinicians and patients alike.

📋 Description

• Design, build, and maintain dashboards, productivity trackers, and KPIs for leadership • Build high-complexity backend data queries for dashboards and ad-hoc projects • Present data findings through visualization tools • Incorporate industry benchmarks into visual metrics • Identify, monitor, and communicate quality and spend metric trends • Investigate, triage, document, and resolve internal and external data quality issues • Create and apply testing algorithms to evaluate large data streams • Audit year-end performance and claims data and report discrepancies • Source, clean, and organize data from payer portals, Rx claims files, SFTP sites, and internal databases • Execute advanced SQL queries in Snowflake for analysis and reporting QA • Develop complex formulas and templates in Google Sheets and Excel • Maintain documentation on analytics, source-of-truth architectures, and peer cross-coverage plans • Assist with work coordination, mentoring junior analysts, training plans, and work-product reviews • Serve as a data subject matter expert and attend meetings in the manager’s absence • Facilitate intradepartmental and cross-functional communication • Perform other duties as assigned

🎯 Requirements

• Bachelor’s degree in a related quantitative field or equivalent professional experience • 4+ years of experience with data management, analysis, QA, and auditing healthcare or payer data • Intermediate SQL programming experience (Snowflake preferred) • Advanced Microsoft Excel / Google Sheets skills (complex formulas, nested functions, pivot tables) • Strong communication skills with the ability to collaborate effectively across remote teams • Proactive mindset with a proven ability to prioritize multiple tasks in a fast-paced environment • Understanding of value-based care/Alternative Payment Models, Medicare, and Non-MSSP quality measures • Experience with statistical software, such as R or Stata • Prolonged periods of sitting at a desk and working on a computer

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