Manager, Provider Operations at Alignment Healthcare USA, LLC in Orange, California

Job Description:

Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.

By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. 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 community.

Position Summary:

The Operations Manager will be responsible for ensuring successful end-to-end implementation and ongoing maintenance of provider contracts across a wide variety of internal operational functions and systems. They will take accountability for the timeliness and accuracy of all implementation and maintenance activities and projects. This role requires comfort working with ambiguity, and the ability to proactively define and execute initiatives in a highly collaborative environment. The role also requires strong communication skills, outstanding organizational skills, and the ability to manage and prioritize competing priorities in a dynamic fast-paced environment.

General Duties/Responsibilities (May include but are not limited to):

• Acts as an extension of market leaders and Network Management; connecting strategic needs with operational requirements and facilitating administrative and tactical execution of activities

• Serves as the single point of operational contact for Network Management and market leaders for assigned regions or markets

• Develops a strong working knowledge of the network strategy and structure, unique or complex provider contracts and emerging operational needs for assigned regions or markets

• Develops and manages work plans, requirements templates, processes, SLAs, tracking mechanisms, tools and project delivery programs

• Provides oversight and governance for projects and assumes overall accountability for their success (timeliness and accuracy)

• Oversees day-to-day activities of assigned Operations staff

• Coordinates with internal Alignment departments to drive consensus on objectives, approach and responsibilities for projects and initiatives

• Ensures project activities are being performed accurately and on time (including Credentialing, Provider Data Management, Configuration, IT, Network Management, Delegation Oversight, etc.)

• Engages directly with Providers, supporting relationship development and ensuring consistent understanding of requirements, project deliverables, timelines and driving requests for and receipt of requested documentation and data

• Continuously identifies and implements process improvements to drive additional value, quality and efficiency of the department

• Serves as subject matter expert and first point of escalation for complex issue resolution for assigned regions or markets

Supervisory responsibilities:

• Supervises a team of analysts and coordinators

• Ensures clear and consistent direction is provided to team

• Monitors performance and delivers positive and corrective feedback as necessary

• Leads / participates in recruiting and hiring activities

• Provides training / onboarding

• Fosters a strong sense of "team" and ensures a positive and productive work environment

Minimum Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Minimum Experience:

a. Background of 3-5 years in healthcare or managed care preferably in a Network Management / Provider Relations / Provider Data Management role

b. Familiarity with value-based healthcare systems

2. Education/Licensure:

a. Bachelor's Degree (BA) from four-year college or university, or one to two years of related experience and/or training, or equivalent combination of education and experience

3. Other:

a. Proven problem-solving skills and ability to translate problem identification into actionable solutions

b. Proactive, self-driven approach to executing strategic and daily work is essential

c. Ability to balance multiple competing priorities simultaneously, while continuing to meet deadlines and quality requirements

d. Ability to collaborate with and lead discussions / presentations with senior leadership across multiple functional areas

e. Ability to proactively identify risks or downstream impacts and develop action plans to address them

f. Strong knowledge of Excel (Pivot tables, VLOOKUP's, Macros). Database and analytical tool experience highly desirable.

g. Very strong organizational skills

h. Ability to translate data into insights; and use those insights to drive outcomes-focused decisions

1. Work Environment
   
   
   1. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
   
   

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.