Payer Operations Analyst

Primary Duties

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.