Payer Operations Analyst

The Payer Data Operations Analyst ensures data quality, accuracy, and reliability across payer data pipelines to support value-based contract performance. This role applies technical data skills and cross-functional leadership to resolve complex data issues, build proactive monitoring solutions, and partner with internal teams and payers to continuously enhance end-to-end data integrity.

Data Triage and Operations

• Identify, triage, route, and resolve data quality issues across Aledade’s 1,200+ payer data feeds.
• Partner with payers and internal teams to address broken SFTP connections, delivery delays, and file transmission failures.
• Coordinate clinical quality submission audits with payers and internal teams by managing audit documentation, organizing patient data files, and locating clinical evidence in collaboration with the Quality Reporting team.
• Maintain accurate contract metadata (i.e. contract names, TINs, and administrative details) to ensure seamless downstream data integration into reporting and product platforms.
• Investigate and resolve manual care gap upload failures to ensure complete and accurate data ingestion.

Cross-Functional Collaboration

• Collaborate with internal teams—including Payer Solutions, Product, Engineering, and Field Operations—and payer partners to intake, investigate, route, and resolve data issues.
• Communicate complex data findings and technical concepts clearly to diverse technical and non-technical stakeholders.
• Lead cross-functional data initiatives from discovery through implementation by mapping workflows, facilitating alignment, delivering actionable recommendations, and establishing clear task ownership and deliverables.
• Serve as a subject matter expert on Aledade’s payer data, analyzing feed and metric anomalies to empower internal teams to optimize patient care and achieve contract objectives.

Program Management

• Maintain standard operating procedures (SOPs) for data issue triage, clinical ingestion troubleshooting, and Primary Source Verification (PSV) audits.
• Enhance long-term data reliability by addressing root causes, advocating for higher-quality payer feeds, and streamlining internal ingestion workflows.

Other duties as assigned

Minimum Qualifications

• Bachelor’s Degree
• 4+ years of experience in data operations, analytics, product management, or related technical roles working with complex data within healthcare, product development, SaaS, or similar environments.
• Intermediate SQL programming experience.
• Technical fluency across various data platforms and tools, including data warehouses, BI and visualization software, file-transfer systems, and workflow management tools (i.e. Snowflake, Databricks, Tableau, SFTP, Jira).
• Demonstrated ability to navigate complex data environments and trace data flows across internal and external systems to identify root causes.
• Proven track record of collaborating in cross-functional teams with the ability to effectively communicate technical insights and business impact to diverse stakeholders.
• Proactive and curious mindset with a drive to understand system architecture, independently navigate complex data ecosystems, and take initiative to continuously optimize processes.

Preferred Qualifications

• Healthcare domain expertise, with a strong understanding of value-based care, Alternative Payment Models (APMs), Medicare, and non-MSSP quality measures.

Physical Requirements

• Prolonged periods of sitting at a desk and working on a computer.