Market Operations Specialist

Astrana Health, Inc.•Cornwall, CT

10d•$70,000 - $81,000•Onsite

About The Position

The Market Operations Specialist serves as the market-level operational lead responsible for coordinating, executing, and optimizing value-based care (VBC) initiatives across clinical, quality, operational, and business functions within the Connecticut market. This role ensures alignment across internal teams, delegated partners, and provider networks to drive performance in quality, cost, risk adjustment, and patient outcomes. The Specialist plays a critical role in preparing the market for downside risk arrangements, closing care gaps, improving population health outcomes, and capturing available incentive revenue tied to payer value-based programs. Our Values: Put Patients First Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence Be Innovative Work As One Team

Requirements

Bachelor’s degree in healthcare administration, public health, business, nursing, or related field OR equivalent experience.
3+ years of experience in healthcare operations, value-based care, managed care, population health, or performance management.
Strong understanding of quality measures (HEDIS, CMS Stars), risk adjustment (HCC), and value-based incentive models.
Ability to interpret performance data, identify trends, and communicate insights effectively.
Excellent project management, organizational, and cross-functional communication skills.

Nice To Haves

Experience working with delegated provider groups, IPAs, ACOs, or clinically integrated networks.
Familiarity with payer reporting tools, clinical quality systems, or care gap management platforms.
Experience supporting downside risk models or population health performance.

Responsibilities

Coordinate and oversee key deliverables for payer value-based care arrangements, ensuring deadlines, reporting, and performance obligations are met.
Track and manage performance metrics, including quality, utilization, risk adjustment, and financial indicators.
Maintain and update provider scorecards, dashboards, and analytics to inform operational priorities and provider engagement strategies.
Partner with Quality, Clinical, and Market Operations teams to implement care gap closure initiatives, quality campaigns, and clinical programs.
Support delegated partners, including CSMS IPA and external clinical/quality leaders, to ensure consistent progress on quality and risk initiatives.
Identify barriers to performance and escalate issues with actionable recommendations.
Serve as a central conduit for communication between payer partners, internal functional teams, and contracted providers.
Provide practices with data-driven insights, opportunities for improvement, and operational guidance to succeed in VBC programs.
Assist with provider education related to VBC workflows, quality measure requirements, incentive programs, and performance expectations.
Support the Manager and market leadership with market-level business planning, VBC strategy execution, and operational readiness for downside risk.
Aid in tracking financial opportunities, shared savings potential, and performance trends.
Facilitate cross-functional meetings and workgroups to ensure aligned execution, accountability, and follow-through across departments.
Consolidate, analyze, and interpret performance data from various sources (payers, clinical systems, internal analytics).
Prepare reports, summaries, and presentations for market leadership, internal stakeholders, and payer performance reviews.
Monitor deliverables from delegated entities to ensure compliance with payer contracts and VBC operational standards.