Michigan Payer Enrollment Operations Manager, Remote
加入一个领导团队,你的工作直接塑造了阿莱达德医生实践如何在基于价值的护理中取得成功。作为密歇根纳税人注册运营经理 (内部:运营经纪人,IPA),你将与 IPA 领导者合作监督我们的合同背后的管理引擎,包括付款人合约,合同会员,支付分销和客户服务提供。你将跨越内部部门合作帮助客户充分利用绩效计划,风险分享安排和基于价值合约,并将领导一支团队,其中可能包括操作专家和会员关系地址说明:由于了解该州的支付人格局和计划的重要性,这是一个偏远的角色。在美国任何地方都会考虑到位的候选人。#LI-CT1 我们是谁:阿莱达德 PBC 是一个公共福利公司,旨在赋予我们医疗保健环境中最具转型性的部分 - - 自主初级护理。我们于2014年成立,从那时起,我们已成为全国最大的初级护卫网络 - - 帮助自主实践,卫生中心和诊所为患者提供更好的服务并以价值为基础的护理发展。此外,通过在各种各样的医疗计划中创建基于价值的合同,我们旨在将传统的服务费模式转换成现象。我们的工作加强了护理连续性,调整了激励措施并确保初级保健医生获得他们所做的最好 - 保持患者健康。如果你想帮助创造一个对病人有益的卫生系统,适用于实践和社会有利的卫生体系 - 如果你渴望加入协作,包容和远程优先文化 - 你已经到正确的地方了。这对你意味着什么?在 Aledade PBC,你将成为一个由热情和尊重,开放心态和学习愿望来解决复杂问题驱动的创造文化的一部分。你将与团队成员合作,他们为他们的工作带来了广泛的经验,兴趣,背景,信仰和成就 - 并所有人都被公共卫生共同的热爱和承诺结合在一起。除了休假时间支持工作生活平衡和享受之外,我们还提供以下综合福利包,旨在帮助团队员的整体福祉:灵活的工作日程安排
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Join a leadership team where your work directly shapes how Aledade’s physician practices succeed in value-based care. As Michigan Payer Enrollment Operations Manager (internally: Operations Manager, IPA), you’ll partner with IPA leadership to oversee the administrative engine behind our contracts, including payer contracts, contract membership, payment distribution, and client services delivery. You’ll collaborate across internal departments to help clients get the most out of pay-for-performance programs, risk sharing arrangements, and value-based contracts, and you’ll lead a team that may include an Operations Specialist and Membership Associates.
Location Note: This is a remote role, with a strong preference for candidates based in Michigan due to the importance of understanding the state’s payer landscape and programs. Candidates located anywhere within the US will be considered.
#LI-CT1
Who We Are:
Aledade PBC, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.
What Does This Mean for You?
At Aledade PBC, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.
In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:
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
And much more!
At Aledade PBC, we don’t just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.
Primary Duties
- Builds respectful, trusting, and productive relationships with Aledade internal departments, payers, and client practices
- Partners with the Market Manager and IPA Operations Director to develop strategic initiatives and operational tracking in key areas such as payer contracting and payments, provider recruiting and membership, population health management, physician alignment, care management oversight, and health information technology
- Monitors payer enrollments, reports, and payments
- Leads payment distribution, payment reporting, and tracking
- Develops, monitors, and reports on Key Performance Indicators related to IPA operations
- Provides care management program oversight, including oversight of the third-party care management function to ensure performance and metric achievement
- Mentors, coaches, and manages direct reports, including overseeing the Operations Specialist and assisting in developing and coordinating meeting communications and notifications
- Oversees the Membership team to ensure complete, accurate, and efficient membership processes
- Responds to queries from customers and potential customers regarding membership, health plan contracts, incentive programs, and IPA information
- Coordinates and runs meetings with payers for contract administration, updates, and issues, and works with payers to resolve issues
- Conducts internal team meetings to develop and communicate overall client strategy, including contract deliverables, progress reports, and implementation plans
- Oversees delivery of client communication and education materials
- Works with the growth department and IPA Operations Director to support recruitment efforts
- Performs other duties as assigned
Minimum Qualifications:
- Bachelor’s degree in Business, Healthcare Administration, or related field or equivalent combination of education and experience
- 8+ years of experience with a health plan, physician organization, physician office or similar employer in progressively more responsible positions
- Strong communication (written and verbal)
- Excellent interpersonal skills with ability to interact effectively and credibly at all levels of an organization.
- Ability to lead, persuade, influence, particularly as it relates to customer relationship development.
- Ability to interact effectively with customers and possess a professional business manner. Must exhibit tact and diplomacy in developing and maintaining positive working relationships.
- Ability to work and interact with a wide range of associates and leaders internal and external to the organization.
- Impeccable service ethic characterized by high energy, a positive attitude and the desire to go “the extra mile” for both clients and teammates.
- A strong analytical and consultative thought process that is effectively utilized to solve customer problems and generate new business opportunities.
- Project management skills with the ability to prioritize multiple projects. Must be able to manage and meet multiple deadlines.
- Must be highly motivated, with superior organization skills, to handle multiple simultaneous projects and associated work teams.
Preferred KSA's:
- Familiarity with Microsoft suite
- Familiarity with Google suite
- Prior management experience preferred
Physical Requirements:
- Work involves extended periods of sitting and using a computer screen.
- Hours may extend beyond the normal workday as needed to serve clients and meet deadlines.