Senior Manager, Performance Economics, Remote

Aledade • Arlington, VA

5d • Remote

About The Position

The Senior Manager, Performance Economics (Service Fund Audit) will support the performance analysis and financial reporting for our Medicare Advantage line of business. The Senior Manager of Performance Economics will perform due-diligence on payer reporting and financial reconciliations. In addition, the position will be responsible for working directly with payer partners and across internal teams to remediate data issues.

Requirements

• Bachelor’s Degree in Healthcare Administration, Business, Public Health, or related field.
• 7+ years of experience related to the business of healthcare. Minimum of 3+ years specialization within Medicare Advantage.
• 2+ year management experience.
• Deep knowledge of value-based care methodologies.
• Deep knowledge of Medicare Advantage methodology and economics (contracting, bidding, P&L management, policy).
• Advanced ability with Excel / Google sheets and data manipulation skills (eg, SQL/SAS/R).
• Ability to collaborate effectively with cross-functional teams and external partners.
• Strong organizational skills with the ability to multitask, prioritize competing demands, and manage time effectively in a fast-paced environment.

Nice To Haves

• Master’s Degree in Healthcare Administration, Business, Public Health, or related field

Responsibilities

• Review payer financial reconciliations for accuracy and adherence to agreed-upon methodologies.
• Support for the development and deployment of audit procedures applied to payer data sets.
• Partner across teams and with payers to resolve data discrepancies. Project manage the contestation process with support from the legal team.
• Collaborate with the Service Fund Audit team to support the build of standard operating procedures, timelines, and workflows to clearly document the end-to-end process that will ensure the accuracy of financial reconciliations and eventual payment to practices.
• Ensure transparency of Service Fund audit work for field teams and provide timely updates and timelines to senior leaders and market stakeholders.
• Serve as the subject matter expert in interpreting payer agreements to ensure accurate calculation of financial reconciliations.
• Support projects relating to portfolio management (eg, practices & contracts) in Medicare Advantage.
• Other duties as assigned.

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
• Number of Employees: 1,001-5,000 employees