Manager, Compliance & Delegate Oversight Reporting and Analytics

ComplianceComplianceOtherRemoteLeadTeam 501-1,000Since 2013H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

106 days ago

Salary

$130K - $195K / year

Seniority

Lead

Job Description

Manager, Compliance & Delegate Oversight Reporting and Analytics

Alignment Health

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Manager of Compliance & Delegate Oversight Reporting & Analytics will serve as the analytical and reporting leader responsible for ensuring visibility, accountability, and regulatory alignment across internal operations and delegated entities (e.g., provider groups, vendors, and MSOs). This role is a working manager. The Manager will oversee delegate monitoring frameworks, reporting tools, and compliance analytics that support regulatory requirements, mitigate risk, and strengthen operations’ audit readiness. This role partners closely with Compliance, Delegation Oversight, Operations, Quality, Legal, Optimization, and external delegates to ensure performance expectations are defined, measured, and actionable. The Manager is expected to operate strategically while being hands-on in producing reporting, performing root-cause analysis, and developing insights that drive compliance and operational improvement. Job Responsibilities: - Own the analytics, reporting, and performance monitoring framework for both internal operations and delegated entities to support regulatory compliance and oversight requirements. - Serve as a hands-on contributor in developing reports, dashboards, and analytics — including writing queries, building visualizations, and synthesizing insights for performance improvement. - Lead the development and maintenance of dashboards and scorecards that measure delegate performance, contractual compliance, corrective action progress, and operational risk indicators. - Partner with Compliance, Delegation Oversight, and Operations teams to define expectations, metrics, and escalation criteria for delegate monitoring. - Conduct root cause analysis and trend evaluations on compliance issues, audit findings, or delegate performance gaps, providing data-backed recommendations for corrective action. - Translate regulatory, contractual, and audit requirements into measurable analytic and reporting structures. - Prepare and validate data and reports to support CMS, state, or internal audits and readiness reviews, including universe build development and reconciliation. - Serve as a subject matter expert on compliance reporting definitions, data structures, and methodologies. - Lead, develop, and manage a team of analysts — assigning work, reviewing deliverables, coaching skill development, and building analytical rigor. - Work with BI, Data Engineering, and IT teams to improve data access, reporting automation, and governance of compliance data sources. - Present findings and risks to leadership and cross-functional stakeholders with clear storytelling and recommended actions. - Other duties and projects not listed above. Supervisory Responsibilities: Manage a team of analysts while also contributing as a hands-on individual contributor. Responsibilities include hiring, training, mentoring, performance management, and establishing analytical standards across the team. Job Requirements: Experience: Required: - 5+ years of experience in healthcare analytics, compliance reporting, regulatory oversight, or delegated entity monitoring. - 2+ years of experience leading analysts or project teams, preferably in a working manager or hybrid leadership role. - Demonstrated experience producing reporting and insights in regulated environments (Medicare Advantage preferred). Preferred: - Experience supporting CMS program audits, reporting submissions, delegation oversight reviews, or corrective action plans. - Experience monitoring delegated entity performance across functions such as claims, encounters, provider data, UM, appeals/grievances, etc. Education: Required: - Bachelor’s degree in Data Analytics, Business, Public Health, Information Systems, Healthcare Administration, or a related field. 4+ additional years of related experience can be used in lieu of a degree. Preferred: - Master’s degree. Training: Required: n/a Preferred: Compliance or regulatory training, delegated oversight, or formal training in Medicare Advantage program requirements. Specialized Skills: Required: - Proficiency in SQL and/or BI tools (Power BI, Tableau, etc.) — including hands-on report and dashboard development. - Ability to translate regulatory and contractual requirements into measurable KPIs and reporting structures. - Strong analytical and critical-thinking skills, including ability to independently investigate issues and synthesize insights. - Excellent written and verbal communication skills, including the ability to present risk, compliance trends, and recommendations to leadership. - Ability to manage multiple priorities and deadlines in a high-visibility environment. Preferred: - Experience with automation, report scheduling, or data quality validation workflows. - Familiarity with CMS reporting and other regulatory / delegation standards. - Exposure to enterprise data governance, MDM standards, or audit frameworks. Licensure: Required: none Preferred: none Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. 2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. Pay Range: $130,332.00 - $195,498.00Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation. *DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.

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