Health Plan Specialist

Employer Industry: Healthcare and Value-Based Care

• Opportunity for career advancement and growth within the organization
• Flexible work schedules and the ability to work remotely
• Health, dental, and vision insurance paid up to 80% for employees, dependents, and domestic partners
• Robust time‑off plan including 21 days of PTO in your first year
• 12 weeks paid parental leave for all new parents
• Celebratory and supportive work environment that values diversity and inclusion

• Establish goals and track key performance indicators (KPIs) related to health service utilization, cost of care, quality measure performance, and shared savings for health plan payer contracts
• Educate market field teams on payer‑specific quality programs and incentives
• Collaborate with cross‑functional stakeholders to develop and deploy market‑level performance strategies around quality, utilization, and cost improvements
• Analyze payer data to identify trends and strategic opportunities within key payer contracts
• Facilitate effective communication among internal and external key stakeholders regarding data, strategy, and operational initiatives

• Bachelor's degree in Health Administration, Public Health, Business, or related field
• 3+ years of experience working with Health Plans and performance analytics
• Strong knowledge of Medicare Advantage, Commercial, and Medicaid performance, including HEDIS measures and STARs performance
• Proficient in Google Sheets or Excel as a data management tool
• Excellent communication (written & verbal), presentation, and interpersonal skills

• Experience in value‑based care
• Experience using Tableau or other data management software

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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.