Payer Enrollment Operations Manager

🔥 38 minutes ago

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $90k - $110k / year

⏰ Full Time

🟠 Senior

🔴 Lead

⚙️ 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

• Partner with IPA leadership to oversee the administrative engine behind payer contracts, contract membership, payment distribution, and client services delivery • Collaborate across internal departments to help clients maximize pay-for-performance programs, risk sharing arrangements, and value-based contracts • Lead a team that may include an Operations Specialist and Membership Associates • Build respectful, trusting, and productive relationships with internal departments, payers, and client practices • Partner with the Market Manager and IPA Operations Director on strategic initiatives and operational tracking • Monitor payer enrollments, reports, and payments • Lead payment distribution, payment reporting, and tracking • Develop, monitor, and report on KPIs related to IPA operations • Provide care management program oversight, including oversight of third-party care management functions • Mentor, coach, and manage direct reports • Oversee Membership team processes • Respond to customer and prospective customer queries regarding membership, health plan contracts, incentive programs, and IPA information • Coordinate payer meetings for contract administration, updates, and issues, and resolve issues with payers • Conduct internal team meetings covering client strategy, contract deliverables, progress reports, and implementation plans • Oversee delivery of client communication and education materials • Support recruitment efforts with the growth department and IPA Operations Director • Perform other duties as assigned

🎯 Requirements

• Bachelor’s degree in Business, Healthcare Administration, or related field or equivalent combination of education and experience • 8+ years of experience with a health plan, physician organization, physician office or similar employer in progressively more responsible positions • Strong communication (written and verbal) • Excellent interpersonal skills with ability to interact effectively and credibly at all levels of an organization • Ability to lead, persuade, and influence, particularly as it relates to customer relationship development • Ability to interact effectively with customers and possess a professional business manner • Tact and diplomacy in developing and maintaining positive working relationships • Ability to work and interact with a wide range of associates and leaders internal and external to the organization • Impeccable service ethic characterized by high energy, a positive attitude and the desire to go “the extra mile” for both clients and teammates • Strong analytical and consultative thought process to solve customer problems and generate new business opportunities • Project management skills with ability to prioritize multiple projects, manage and meet multiple deadlines • Superior organization skills to handle multiple simultaneous projects and associated work teams • Familiarity with Microsoft suite • Familiarity with Google suite • Prior management experience preferred • Work involves extended periods of sitting and using a computer screen • Hours may extend beyond the normal workday as needed to serve clients and meet deadlines

🏖️ Benefits

• Flexible work schedules and the ability to work remotely are available for many roles • Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners • Robust time-off plan (21 days of PTO in your first year) • Two paid volunteer days and 11 paid holidays • 12 weeks paid parental leave for all new parents • Six weeks paid sabbatical after six years of service • Educational Assistant Program and Clinical Employee Reimbursement Program • 401(k) with up to 4% match • Stock options • Bonus • Equal opportunity employment