aledade - Payer Operations Analyst
Requirements
• Bachelor’s Degree • 4+ years of experience in data operations, analytics, product management, or related technical roles working with complex data within healthcare, product development, SaaS, or similar environments. • Intermediate SQL programming experience. • Technical fluency across various data platforms and tools, including data warehouses, BI and visualization software, file-transfer systems, and workflow management tools (i.e. Snowflake, Databricks, Tableau, SFTP, Jira). • Demonstrated ability to navigate complex data environments and trace data flows across internal and external systems to identify root causes. • Proven track record of collaborating in cross-functional teams with the ability to effectively communicate technical insights and business impact to diverse stakeholders. • Proactive and curious mindset with a drive to understand system architecture, independently navigate complex data ecosystems, and take initiative to continuously optimize processes. • Healthcare domain expertise, with a strong understanding of value-based care, Alternative Payment Models (APMs), Medicare, and non-MSSP quality measures. • Prolonged periods of sitting at a desk and working on a computer.
Responsibilities
• Data Triage and Operations • Identify, triage, route, and resolve data quality issues across Aledade’s 1,200+ payer data feeds. • Partner with payers and internal teams to address broken SFTP connections, delivery delays, and file transmission failures. • Coordinate clinical quality submission audits with payers and internal teams by managing audit documentation, organizing patient data files, and locating clinical evidence in collaboration with the Quality Reporting team. • Maintain accurate contract metadata (i.e. contract names, TINs, and administrative details) to ensure seamless downstream data integration into reporting and product platforms. • Investigate and resolve manual care gap upload failures to ensure complete and accurate data ingestion. • Cross-Functional Collaboration • Collaborate with internal teams—including Payer Solutions, Product, Engineering, and Field Operations—and payer partners to intake, investigate, route, and resolve data issues. • Communicate complex data findings and technical concepts clearly to diverse technical and non-technical stakeholders. • Lead cross-functional data initiatives from discovery through implementation by mapping workflows, facilitating alignment, delivering actionable recommendations, and establishing clear task ownership and deliverables. • Serve as a subject matter expert on Aledade’s payer data, analyzing feed and metric anomalies to empower internal teams to optimize patient care and achieve contract objectives. • Program Management • Maintain standard operating procedures (SOPs) for data issue triage, clinical ingestion troubleshooting, and Primary Source Verification (PSV) audits. • Enhance long-term data reliability by addressing root causes, advocating for higher-quality payer feeds, and streamlining internal ingestion workflows.
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