Serve as the subject matter expert in interpreting payer agreements and practice participation terms to ensure accurate calculation and distribution of care coordination fees, quality bonuses, and other payments.
Collaborate with the Provider Network Operations team to support the build of standard operating procedures, timelines, and workflows to clearly document the end-to-end process that will ensure timely execution of payments to practices. Provide inputs for mapping payment files, identifying required fields for data ingestion and defining payment calculation logic. Maintain reconciliation trackers to measure contract performance and support audit requests.
Oversee the receipt, validation, and processing of payments based on contractual requirements. Collaborate across teams and with payers to resolve discrepancies. Process any payments that fall outside of the automation process.
Partner with Accounting to ensure proper classification of payments by contract, line of business, and payment type.
Ensure transparency of payment distributions for field teams and provide timely updates and timelines to market stakeholders via dashboards or other communication channels.
Support for the development and execution of shared savings distribution formulas.
Review payments processed by Data Analyst for accuracy.

Bachelor’s Degree in business, health administration, public policy, or related field.
5+ years of experience related to the business of healthcare.
1 + year management experience
Proficiency in SQL, Microsoft Excel/Google Sheets

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!

Aledade, Inc.

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