Payer Enrollment Operations Manager, Remote

Posted 10 Days Ago
Be an Early Applicant
4 Locations
In-Office or Remote
90K-110K Annually
Senior level
Healthtech
Aledade is the largest network of independent primary care.
The Role
Oversee Michigan payer enrollment and IPA operations, including payer contracts, membership, payment distribution, KPI reporting, care management oversight, client services, and payer issue resolution. Lead and develop operations and membership staff, coordinate internal and external meetings, support provider recruitment, and ensure contract deliverables and client communications are completed effectively.
Summary Generated by Built In
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.
 
 

Skills Required

  • Bachelor's degree in Business, Healthcare Administration, or a related field, or equivalent education and experience
  • 8 or more years of experience with a health plan, physician organization, physician office, or similar employer
  • Strong written and verbal communication skills
  • Excellent interpersonal skills and ability to interact effectively at all organizational levels
  • Ability to lead, persuade, and influence, particularly in customer relationship development
  • Professional customer service manner with tact and diplomacy
  • Ability to work effectively with internal and external associates and leaders
  • Strong service ethic, positive attitude, high energy, and client-focused approach
  • Strong analytical and consultative problem-solving skills
  • Project management skills with ability to prioritize projects and meet multiple deadlines
  • Superior organizational skills and ability to manage simultaneous projects and work teams
  • Familiarity with Microsoft Suite
  • Familiarity with Google Suite
  • Prior management experience

Aledade Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Aledade and has not been reviewed or approved by Aledade.

  • Fair & Transparent Compensation — Pay is often characterized as fair or pretty good for the work, with occasional remarks that compensation is among the best experienced in a career.
  • Leave & Time Off Breadth — Time off provisions stand out, including a strong PTO allotment early on and an additional long-tenure sabbatical benefit.
  • Parental & Family Support — Paid parental leave is positioned as a meaningful, broadly applicable benefit for new parents.

Aledade Insights

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The Company
HQ: Bethesda, MD
1,500 Employees
Year Founded: 2014

What We Do

Aledade is the largest network of independent primary care, enabling clinicians to deliver better patient outcomes and generate more savings revenue through value-based care. Aledade’s data, personal coaching, user-friendly workflows, health care policy expertise, strong payer relationships and integrated care solutions enable primary care organizations to succeed financially by keeping people healthy. Together with more than 1,900 practices and community health centers in 45 states and the District of Columbia, Aledade manages accountable care organizations that share in the risk and reward across more than 200 value-based contracts representing more than 2.5 million patient lives. To learn more, visit www.aledade.com or follow on X (Twitter), Facebook or LinkedIn.

Why Work With Us

At Aledade, we’re all about doing good for patients, practices and society - which is why we’re so passionate about value-based care and the work we do every day. Because we’re working to benefit all of society, we believe the best way to do so is to utilize all of our team members and their unique experiences, interests, backgrounds and beliefs.

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