Health Plan Performance Specialist

Aledade • Atlanta, GA

6h • Remote

About The Position

The Health Plan Performance (HPP) Specialist serves as a critical strategic partner and primary liaison between Aledade and our payer partners. This role is responsible for the end-to-end orchestration of health plan performance strategies, ensuring that our Medicare Advantage, Commercial, and Medicaid contracts are meeting and exceeding financial and clinical benchmarks. Beyond mere oversight, the Specialist acts as a bridge between high-level payer data and on-the-ground execution, translating complex analytics into actionable market strategies that drive shared savings, improve quality scores, and lower the total cost of care. As a subject matter expert, you will navigate a high-visibility environment, collaborating with cross-functional leadership and market field teams to solve complex operational challenges and solidify Aledade’s position as a leader in value-based care.

Requirements

• Bachelor's degree in Health Administration, Public Health, Business, or related field
• 3+ yrs experience working with Health Plans and performance analytics
• Strong knowledge of Medicare Advantage, Commercial, and Medicaid performance; Knowledge of HEDIS measures and STARs performance
• Proficient in Google Sheets or Excel as a data management tool
• Strong analytical skills and attention to detail
• Excellent communication (Written & Verbal), presentation, and interpersonal skills; Ability to work will various levels of stakeholders
• Strong strategic thinking and problem-solving skills
• Strong organizational skills; Ability to manage multiple projects and deliver results

Nice To Haves

• Experience in value based care
• Experience using Tableau or other data management software

Responsibilities

• Establish goals and track key performance indicators (KPIs) related to health service utilization, cost of care, quality measure performance, and shared savings for health plan payer contracts (Medicare Advantage, Commercial and Medicaid)
• Educate market field teams on payer-specific quality programs and incentives
• Lead internal and external stakeholder engagements on behalf of HPP Managers and Directors as needed
• Serves as a subject matter expert for the HPP Analysts; Train and onboard new HPP analysts on payer strategy and internal Aledade tools
• Collaborate with cross-functional stakeholders (Affordability, Quality, and Risk) to develop and deploy market-level performance strategies around quality, utilization, and cost improvements
• Facilitate effective communication amongst internal and external key stakeholders regarding data, strategy, and operational initiatives
• Analyze payer data to identify trends and strategic opportunities within key payer contracts.
• Synthesize internal and external reporting data into actionable performance strategies
• Articulate analytical requests to analytics teams as needed

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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level