Sr. Health Plan Operations Analyst

The Sr. Analyst, Health Plan Performance (HPP) Ops is responsible for extracting, analyzing, and transforming complex health plan data into actionable strategic insights. This role drives dashboard creation, leads rigorous quality assurance auditing, and provides cross-functional leadership and mentorship to optimize value-based care contract performance. Primary Duties Dashboard Creation & Analytical Design 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. Auditing & Quality Assurance 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. Day-to-Day Operations 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. Leadership Support 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 Minimum Qualifications 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. Preferred Qualifications Understanding of value-based care/Alternative Payment Models, Medicare, and Non-MSSP quality measures Experience with statistical software, such as R or Stata Physical Requirements Prolonged periods of sitting at a desk and working on a computer. $66,000 - $79,000 a year We may use automated tools, including artificial intelligence (AI), to help organize and evaluate application materials. These tools support our recruiters and hiring managers by helping manage large applicant pools. Human judgment plays an essential role in our hiring process, including in the oversight and use of any automated tools. If you would like more information about our screening and hiring process, please contact us. Our Commitment to Authenticity. We use Endorsed, a fraud detection tool, to validate the authenticity of applications and protect against identity fraud. This ensures we are connecting with real people and allows us to prioritize genuine candidates. When you apply to a job on this site, the personal data contained in your application will be collected by Aledade PBC using Lever, a cloud services provider located in the United States. Lever is engaged by Aledade PBC to help manage its recruitment and hiring processes. For more information about how your personal data will be processed by Aledade PBC and any rights you may have, please review Aledade PBC’s Candidate Privacy Notice. By applying for this job, you agree to Aledade’s Applicant Privacy Policy available at https://www.aledade.com/privacy-policy-applicants If you have any questions about our privacy practices, please contact [email protected].