Manager - VBC Attribution and Operations

Duly Health and CareDowners Grove, IL
13d$92,000 - $138,000

About The Position

The Manager, Population Attribution and Operations will oversee membership attribution processes across Medicare Advantage, Medicare, MSSP, and commercial risk arrangements. This role is critical to ensuring accurate population alignment, driving operational efficiency, and supporting regulatory compliance in our value-based care programs. This role will manage day-to-day attribution operations, analyze membership data, collaborate with payers and internal teams, and ensure all processes are audit-ready and compliant with CMS and payer rules.

Requirements

  • Bachelor’s degree in Healthcare Administration, Public Health, Business, or a related field, or equivalent experience.
  • 3–5+ years of experience in healthcare operations, with experience in a Value-Based Care organization, ACO, or payer environment strongly preferred.
  • Experience managing membership, eligibility, and attribution processes.
  • Proficiency in analyzing large datasets and translating findings into operational actions.
  • Experience developing or maintaining standardized workflows/SOPs for membership, attribution, and panel management.
  • Strong analytical and quantitative skills with the ability to translate complex data into actionable insights.
  • Excellent presentation and communication skills for collaboration with senior leadership and cross-functional teams.
  • Advanced Excel skills and experience with BI tools (Power BI, Tableau, or similar) preferred.
  • Knowledge of Medicare Advantage, DSNP, and ACO attribution rules.
  • Strong attention to detail, organization, and ability to manage multiple priorities in a fast-paced environment.
  • Ability to develop and maintain standardized workflows and SOPs.
  • Strong problem-solving skills and ability to navigate complex membership and eligibility issues.
  • Comfortable working directly with payer partners to resolve discrepancies and ensure alignment.

Nice To Haves

  • Experience automating and improving membership reporting, reconciliation processes, and dashboarding is a plus.

Responsibilities

  • Attribution Operations & Execution (40%)
  • Support interpretation, documentation, and application of payer attribution and de-attribution rules.
  • Maintain accurate and timely membership operations, including validation of attribution and de-attribution lists.
  • Develop and follow structured workflows to ensure consistent attribution processing and PCP updates.
  • Prepare and submit attribution change requests to payers; maintain organized, audit-ready records of submissions and outcomes.
  • Data Analysis, Accuracy & Problem Solving (25%)
  • Review membership trends and patient activity to identify discrepancies, operational gaps, and opportunities to improve attribution accuracy.
  • Research and explain drivers of misaligned or missing attribution to clinical and operational partners.
  • Assist in evaluating financial and operational impacts of attribution changes by collaborating with Analytics and Marketing to support membership performance.
  • Payer & Cross-Functional Collaboration (20%)
  • Build cooperative, reliable relationships with payers to support clear communication, timely clarification, and consistent membership alignment.
  • Share membership and attribution insights with senior leaders; collaborate across teams to support operational decisions and membership-related processes.
  • Regulatory Awareness & Continuous Improvement (15%)
  • Stay informed on regulatory updates, payer policy changes, and CMS guidance to anticipate membership impacts and ensure appropriate adjustments.
  • Contribute to continuous improvement by recommending enhancements that increase accuracy, efficiency, and compliance.
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