Michigan Payer Enrollment Operations Manager, Remote
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Description
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.
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.
#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.
As published by lever · 16 questions · 2 written answers
Basics
Which location are you applying for?, Resume/CV, Full name, Email, Phone, Current location, Current company, LinkedIn URL, Twitter URL, GitHub URL, Portfolio URL, Other website
Short answers (3)
- How did you learn about Aledade?
- What is your desired compensation for this position?
- Current city and state of residence?
Pick from a list (11)
- Are you legally eligible to work in the United States?
- Do you currently require the company’s sponsorship or need the company’s assistance to obtain or maintain authorization to work legally in the United States? This includes, but is not limited to, H-1B visas (lottery and transfers), TN visas, E-3 visas, or other company-sponsored visas.
- In the future, will you require the company’s sponsorship or need the company’s assistance to obtain or maintain authorization to work legally in the United States? This includes, but is not limited to, H-1B visas (lottery and transfers), TN visas, E-3 visas, or other company-sponsored visas.
- Are you currently employed by an Aledade Partner Practice?
- Please list the state that you plan to be physically located in while employed with our company? For employment at Aledade, it is required to be located within the United States; even for remote based roles. optional
- Are you subject to an agreement with a former employer or other party (such as non-competition or non-solicitation agreement) that might, in any way, restrict your ability to work for our Company?
- Would you like to opt-in to receiving text messages for this role regarding the hiring process (e.g., interview requests and reminders)? Note: Selecting “No” will not eliminate you from consideration. Message and data rates may apply. You can opt-out at any time by replying “STOP.”
- By clicking "Submit Application" I agree to the Aledade Applicant Privacy Policy & Terms of Service - https://www.aledade.com/privacy-policy-applicants optional
- By clicking "Submit Application" I certify that all statements made in this application are true and complete. I understand that any falsification, misrepresentation, or omission of fact is sufficient cause for my removal from consideration for employment or my dismissal if hired optional
- Have you personally managed provider or practice enrollment with health plans or payers, such as submitting applications, tracking status, and resolving enrollment issues?
- Have you personally handled provider credentialing or recredentialing, such as collecting and verifying documentation, working with payers or credentialing bodies, and tracking expirations?
Written answers (2)
- Please describe your hands-on experience with provider enrollment and credentialing, including your role and the number of providers you handled.
- Briefly describe a time you coached or managed a team member whose work was not meeting expectations. What did you do, and what changed as a result?