Provider Operations Transformation Director

Alignment Health; United States; Remote; USD 130,000 - 195,000; Full time

Job summary

Alignment Health is seeking a Provider Lifecycle Director - Transformation to lead multi-year strategies for improving provider operations across our health plan. You will partner with Operations, Network Management, Clinical Ops, Technology, Analytics, Compliance, Finance, and market leadership to redesign processes and implement scalable operating models.

You will own initiatives across Claims, Credentialing, Provider Data Management, Prior Authorization, Provider Services, and Contract

Qualifications

• Minimum 8 years of experience in healthcare operations, transformation, or related fields.
• Minimum 5 years leading large-scale cross-functional transformation initiatives.
• Experience redesigning processes and implementing operating model improvements with measurable results.
• Experience leading complex initiatives with multiple executives and functions.
• Experience developing business cases, roadmaps, and executive presentations.
• Experience managing technology, operations, and organizational change initiatives.

Responsibilities

• Define and execute a multi-year strategy to improve provider operations.
• Establish a portfolio of transformation initiatives across provider functions.
• Identify opportunities to improve efficiency, compliance, and provider experience.
• Develop business cases, investment plans, and success metrics.
• Design and implement operating models across provider functions.
• Lead technology enablement and automation to support transformation efforts.
• Establish KPIs, monitor results, and report on ROI.

Skills

Provider Operations Strategy

Operating Model Design

Business Process Improvement

Digital Transformation

Data Analytics & Performance

Organizational Change Mgmt

Cross-Functional Leadership

Strategic Planning & Execution

Executive Communication

Education

Bachelor’s degree in Healthcare Administration, Business Administration, or related field

MBA or MHA preferred

Tools

Lean

Six Sigma

Agile

Project Management

Human-Centered Design

Change Management

Job description

Alignment Health is seeking a Provider Lifecycle Director - Transformation to lead multi-year strategies for improving provider operations across our health plan. You will partner with Operations, Network Management, Clinical Ops, Technology, Analytics, Compliance, Finance, and market leadership to redesign processes and implement scalable operating models.

You will own initiatives across Claims, Credentialing, Provider Data Management, Prior Authorization, Provider Services, and Contract