[Remote] Sr. Health Plan Operations Analyst

Note: The job is a remote job and is open to candidates in USA. Aledade is hiring a Senior Health Plan Operations Analyst to turn complex health plan data into actionable insights that improve value-based care contract performance. The role builds dashboards, performs data quality audits and analysis, and supports cross-functional operations and analyst development.

Responsibilities

• Design, build and maintain dashboards, productivity trackers, and KPIs utilized by leadership to improve market performance and daily operations
• Build high-complexity queries of back-end data to power dashboards and custom ad-hoc projects
• Present data findings clearly through visualization tools to ensure understanding among diverse stakeholders and colleagues
• Incorporate industry benchmarks into visual metrics (charts, graphs, pivot tables) to show baseline and current states
• Identify, monitor, and communicate changes or trends in quality and spend metrics
• Act as the first line of defense investigating, triaging, documenting, and resolving internal and external data quality issues
• Create and apply testing algorithms to evaluate large data streams throughout the system data flow
• Audit year-end performance and claims data for discrepancies, reporting errors to payer teams for swift resolution
• Source, clean, and organize data from multiple streams (payer portals, Rx claims files, SFTP sites, and internal databases)
• Execute advanced SQL queries in Snowflake to supplement payer data for analysis and reporting QA
• Develop complex formulas and templates in Google Sheets and Excel to streamline repetitive data tasks
• Maintain comprehensive documentation regarding operational analytics, source-of-truth architectures, and peer cross-coverage plans
• Assist the manager with work coordination, mentoring junior analysts, developing training plans, and reviewing team work products
• Serve as a data subject matter expert (SME); attend meetings in the manager's absence
• Facilitate clear intradepartmental and cross-functional communication among key stakeholders
• Other duties as assigned

Skills

• Bachelor's degree in a related quantitative field or equivalent professional experience
• 4+ years of experience with data management, analysis, QA, and auditing healthcare or payer data
• Intermediate SQL programming experience (Snowflake preferred)
• Advanced Microsoft Excel / Google Sheets skills (complex formulas, nested functions, pivot tables)
• Strong communication skills with the ability to collaborate effectively across remote teams
• Proactive mindset with a proven ability to prioritize multiple tasks in a fast-paced environment
• Understanding of value-based care/Alternative Payment Models, Medicare, and Non-MSSP quality measures
• Experience with statistical software, such as R or Stata

Benefits

• Remote work

Company Overview

Company H1B Sponsorship