Provider Lifecycle Director - Transformation

Posted 16 Days Ago
Be an Early Applicant
The Center, IN, USA
In-Office
130K-195K Annually
Senior level
Healthtech • Database
The Role
Leads enterprise transformation of provider operations across claims, credentialing, provider data, prior authorization, contracting, delegation oversight, and provider services. Defines strategy, operating models, process improvements, technology priorities, KPIs, business cases, and governance. Partners with executives and cross-functional teams to implement automation, AI-enabled capabilities, digital workflows, and scalable processes that improve efficiency, compliance, provider experience, and measurable business outcomes.
Summary Generated by Built In

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Provider Lifecycle Director - Transformation is responsible for defining and executing the strategy to improve provider operations across the health plan. This role leads initiatives that improve operational performance, strengthen compliance, reduce administrative costs, and support growth.
The Director partners across Provider Operations, Network Management, Clinical Operations, Technology, Analytics, Compliance, Finance, and market leadership to redesign processes, implement technology solutions, and establish scalable operating models.
This role is accountable for transformation initiatives across Claims Operations, Credentialing, Provider Data Management, Prior Authorization, Provider Services, Delegation Oversight, and Contract Administration. Responsibilities include process redesign, technology enablement, operating model improvements, and delivery of measurable business outcomes.

Provider Operations Strategy & Transformation

  • Define and execute a multi-year strategy to improve provider operations.
  • Establish and manage a portfolio of transformation initiatives across provider functions.
  • Identify opportunities to improve efficiency, scalability, compliance, accuracy, and provider experience.
  • Develop business cases, investment plans, and success measures.

Operating Model Design

  • Design and implement operating models across provider operations functions.
  • Develop workflows, governance structures, service models, and accountability frameworks.
  • Simplify processes, eliminate redundancies, and improve cross-functional coordination.
  • Establish sustainable operating practices that support long-term business objectives.

Process Improvement

  • Lead process redesign initiatives across Claims, Credentialing, Provider Data Management, Prior Authorization, Contracting, Delegation Oversight, and Provider Services.
  • Identify root causes of operational inefficiencies, provider friction, quality issues, and compliance risks.
  • Apply process improvement methodologies, automation, and industry best practices.
  • Standardize workflows and operating procedures where appropriate.

Technology & Digital Enablement

  • Partner with Product, Technology, and Operations teams to define provider operations technology priorities.
  • Translate business requirements into scalable technology solutions.
  • Lead implementation of automation, AI-enabled capabilities, digital intake solutions, provider portals, and workflow platforms.
  • Ensure technology investments improve productivity, accuracy, and turnaround times.

Performance & Operational Outcomes

  • Establish KPIs and performance measures for transformation initiatives.
  • Monitor results and ensure initiatives deliver measurable business value and return on investment.
  • Develop executive reporting and dashboards.
  • Drive accountability for operational improvements.

Leadership & Governance

  • Serve as the primary liaison across Provider Operations, Network Management, Clinical Operations, Technology, Analytics, Compliance, Finance, and market leadership.
  • Facilitate executive governance forums and steering committees.
  • Build stakeholder alignment and drive adoption of new processes, operating models, and technologies.
  • Influence leaders across the organization to achieve transformation goals.

Supervisory Responsibilities:  

This role is an individual contributor.

Job Requirements:

Experience:
Required:

  • Minimum 8 years of experience in healthcare operations, business transformation, operational excellence, consulting, or related functions.
  • Minimum 5 years leading large-scale cross-functional transformation initiatives.
  • Experience redesigning operational processes and implementing operating model improvements that delivered measurable results.
  • Experience leading complex initiatives involving multiple functions and executive stakeholders.
  • Experience developing business cases, transformation roadmaps, performance frameworks, and executive presentations.
  • Experience managing initiatives involving technology, operations, and organizational change.
     

Preferred:

  • Medicare Advantage experience.
  • Experience leading transformation, process improvement, or operational excellence functions.
  • Consulting experience supporting healthcare transformation.
  • Experience implementing AI, automation, digital transformation, or workflow technologies.
  • Experience supporting rapid growth and operational scaling.

Education:

Required:

  • Bachelor's degree in Healthcare Administration, Business Administration, or a related field; four years of additional directly related experience may substitute for a degree.

Preferred:

  • MBA, MHA, or equivalent graduate degree.
  • Training in Lean, Six Sigma, Agile, Project Management, Human-Centered Design, or Change Management.
  • Relevant certification in process improvement, project management, or transformation methodologies.

Training:

Required:

  • Knowledge of healthcare delivery models, provider performance management, referral management, care routing, and value-based care principles.

Preferred:

  • Training in product management, digital transformation, change management, or healthcare operations leadership.
  • Lean, Six Sigma, or other process improvement methodologies.

Specialized Skills:

Required:

  • Provider Operations Strategy & Transformation (Advanced): Ability to develop and execute strategies that improve provider operations, performance, scalability, compliance, and provider experience.
  • Operating Model Design (Advanced): Ability to design scalable operating models, workflows, governance structures, and service delivery frameworks.
  • Business Process Improvement (Advanced): Ability to evaluate complex operational processes, identify root causes, and implement solutions that improve efficiency, quality, and performance.
  • Digital Transformation & Technology Enablement (Advanced): Ability to prioritize technology investments and implement solutions that improve operational performance and workforce productivity.
  • Data Analytics & Performance Management (Advanced): Ability to establish KPIs, assess performance, identify improvement opportunities, and translate data into actionable recommendations.
  • Organizational Change Management (Advanced): Ability to lead large-scale change initiatives and drive adoption of new processes, technologies, and operating models.
  • Cross-Functional Leadership & Influence (Advanced): Ability to align stakeholders across Operations, Clinical Services, Technology, Analytics, Compliance, Finance, and business leadership teams.
  • Strategic Planning & Execution (Advanced): Ability to develop long-term plans, prioritize investments, establish governance, and deliver measurable business outcomes.
  • Executive Communication & Stakeholder Management (Advanced): Ability to develop executive presentations, business cases, operating reviews, and recommendations for senior leadership.
Pay Range: $130,332.00 - $195,498.00

Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].

Skills Required

  • Minimum 8 years of experience in healthcare operations, business transformation, operational excellence, consulting, or related functions
  • Minimum 5 years leading large-scale cross-functional transformation initiatives
  • Experience redesigning operational processes and implementing operating model improvements that delivered measurable results
  • Experience leading complex initiatives involving multiple functions and executive stakeholders
  • Experience developing business cases, transformation roadmaps, performance frameworks, and executive presentations
  • Experience managing initiatives involving technology, operations, and organizational change
  • Bachelor's degree in Healthcare Administration, Business Administration, or a related field; four years of additional directly related experience may substitute for a degree
  • Knowledge of healthcare delivery models, provider performance management, referral management, care routing, and value-based care principles
  • Medicare Advantage experience
  • Experience leading transformation, process improvement, or operational excellence functions
  • Consulting experience supporting healthcare transformation
  • Experience implementing AI, automation, digital transformation, or workflow technologies
  • Experience supporting rapid growth and operational scaling
  • MBA, MHA, or equivalent graduate degree
  • Training in Lean, Six Sigma, Agile, Project Management, Human-Centered Design, or Change Management
  • Relevant certification in process improvement, project management, or transformation methodologies
  • Training in product management, digital transformation, change management, or healthcare operations leadership
  • Lean, Six Sigma, or other process improvement methodologies

Alignment Healthcare Compensation & Benefits Highlights

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

  • Healthcare Strength — Core coverage includes multiple medical plan types with major carriers along with dental and vision. Options are described as comprehensive on paper and can include plan choice depending on role and location.
  • Retirement Support — A 401(k) plan with company match is commonly offered, and some roles also receive equity via RSUs. This foundation strengthens total rewards even when base pay varies by job family.
  • Leave & Time Off Breadth — PTO is offered with paid holidays, and some teams provide paid parental leave; clinical roles may include CME time and tuition reimbursement. These elements expand beyond basic medical benefits to support time away and professional development.

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The Company
HQ: Orange, CA
749 Employees
Year Founded: 2013

What We Do

Alignment Healthcare is redefining the business of health care by shifting the focus from payments to people. We’ve created a new model for health care delivery that cuts costs and improves lives by unraveling the inefficiencies of the current system to drive patients, providers and payers toward a common goal of wellness. Harnessing best practices from Medicare Advantage, our innovative data-management technology allows us to commit to caring for seniors and those who need it most: the chronically ill and frail. Alignment Healthcare provides partners and patients with customized care and service where they need it and when they need it, including clinical coordination, risk management and technology facilitation. Alignment Healthcare offers health plan options through Alignment Health Plan, and also partners with select health plans to help deliver better benefits at lower costs. For more information, please visit www.alignmenthealthcare.com.

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