Provider Lifecycle Director – Transformation

Job not on LinkedIn

🔥 7 minutes ago

🇺🇸 United States – Remote

💵 $130.3k - $195.5k / year

⏰ Full Time

🔴 Lead

👔 Director

👻 Ghost score 0%

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Alignment Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

🛡️ Insurance

🏥 Healthcare

💰 $135M Series C on 2020-03

Healthcare Insurance • Insurance • Healthcare

Alignment Health is dedicated to providing comprehensive care for Medicare members, emphasizing the needs of seniors, the chronically ill, and those who are frail. With a mission to transform senior healthcare, Alignment Health leverages a tailored care model and advanced technology to deliver high-quality, low-cost healthcare services. Their 24/7 concierge care team collaborates with trusted local providers to ensure that every member receives personalized care, reflecting the company's commitment to treating all members as valued family members.

📋 Description

• Define and execute a multi-year strategy to improve provider operations • Establish and manage a portfolio of transformation initiatives across provider functions • Identify opportunities to improve efficiency, scalability, compliance, accuracy, and provider experience • Develop business cases, investment plans, and success measures • Design and implement operating models across provider operations functions • Develop workflows, governance structures, service models, and accountability frameworks • Simplify processes, eliminate redundancies, and improve cross-functional coordination • Lead process redesign initiatives across Claims, Credentialing, Provider Data Management, Prior Authorization, Contracting, Delegation Oversight, and Provider Services • Apply process improvement methodologies, automation, and industry best practices • Partner with Product, Technology, and Operations teams to define technology priorities and implement scalable solutions • Lead implementation of automation, AI-enabled capabilities, digital intake solutions, provider portals, and workflow platforms • Establish KPIs and performance measures, monitor results, and ensure measurable business value and return on investment • Develop executive reporting and dashboards • Serve as primary liaison across Provider Operations, Network Management, Clinical Operations, Technology, Analytics, Compliance, Finance, and market leadership • Facilitate executive governance forums and steering committees • Build stakeholder alignment and drive adoption of new processes, operating models, and technologies • Operate as an individual contributor

🎯 Requirements

• Minimum 8 years of experience in healthcare operations, business transformation, operational excellence, consulting, or related functions • Minimum 5 years leading large-scale cross-functional transformation initiatives • Experience redesigning operational processes and implementing operating model improvements that delivered measurable results • Experience leading complex initiatives involving multiple functions and executive stakeholders • Experience developing business cases, transformation roadmaps, performance frameworks, and executive presentations • Experience managing initiatives involving technology, operations, and organizational change • Bachelor's degree in Healthcare Administration, Business Administration, or a related field; four years of additional directly related experience may substitute for a degree • Knowledge of healthcare delivery models, provider performance management, referral management, care routing, and value-based care principles • Advanced ability in provider operations strategy and transformation • Advanced ability in operating model design • Advanced ability in business process improvement • Advanced ability in digital transformation and technology enablement • Advanced ability in data analytics and performance management • Advanced ability in organizational change management • Advanced cross-functional leadership and influence • Advanced strategic planning and execution • Advanced executive communication and stakeholder management