Market Operations Specialist

Market Operations Specialist

Location:

Connecticut, USA

Department: HS - ACM

Compensation: $70,000 - $81,000 / year

Overview

The Market Operations Specialist serves as the market-level operational lead responsible for coordinating, executing, and optimizing value-based care (VBC) initiatives across clinical, quality, operational, and business functions within the Connecticut market. This role ensures alignment across internal teams, delegated partners, and provider networks to drive performance in quality, cost, risk adjustment, and patient outcomes. The Specialist plays a critical role in preparing the market for downside risk arrangements, closing care gaps, improving population health outcomes, and capturing available incentive revenue tied to payer value-based programs.

Our

Values

• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity & Excellence
• Be Innovative
• Work As One Team

What You'll Do Value-Based Care Program Execution

• Coordinate and oversee key deliverables for payer value-based care arrangements, ensuring deadlines, reporting, and performance obligations are met.
• Track and manage performance metrics, including quality, utilization, risk adjustment, and financial indicators.
• Maintain and update provider scorecards, dashboards, and analytics to inform operational priorities and provider engagement strategies.

Performance Improvement & Care Gap Management

• Partner with Quality, Clinical, and Market Operations teams to implement care gap closure initiatives, quality campaigns, and clinical programs.
• Support delegated partners, including CSMS IPA and external clinical/quality leaders, to ensure consistent progress on quality and risk initiatives.
• Identify barriers to performance and elevate issues with actionable recommendations.

Provider Engagement & Communication

• Serve as a central conduit for communication between payer partners, internal functional teams, and contracted providers.
• Provide practices with data‑driven insights, opportunities for improvement, and operational guidance to succeed in VBC programs.
• Assist with provider education related to VBC workflows, quality measure requirements, incentive programs, and performance expectations.

Operational Coordination & Market Support

• Support the Manager and market leadership with market‑level business planning, VBC strategy execution, and operational readiness for downside risk.
• Aid in tracking financial opportunities, shared savings potential, and performance trends.
• Facilitate cross‑functional meetings and work groups to ensure aligned execution, accountability, and follow‑through across departments.

Data & Reporting

• Consolidate, analyze, and interpret performance data from various sources (payers, clinical systems, internal analytics).
• Prepare reports, summaries, and presentations for market leadership, internal stakeholders, and payer performance reviews.
• Monitor deliverables from delegated entities to ensure compliance with payer contracts and VBC operational standards.

Qualifications Required:

• Bachelor’s degree in healthcare administration, public health, business, nursing, or related field OR equivalent experience.
• 3+ years of experience in healthcare operations, value-based care, managed care, population health, or performance management.
• Strong understanding of quality measures (HEDIS, CMS Stars), risk adjustment (HCC), and value-based incentive models.
• Ability to interpret performance data, identify trends, and communicate insights effectively.
• Excellent project management, organizational, and cross-functional communication skills.

Preferred:

• Experience working with delegated provider groups, IPAs, ACOs, or clinically integrated networks.
• Familiarity with payer reporting tools, clinical quality systems, or care gap management platforms.
• Experience supporting downside risk models or population health performance.

Environmental

Job Requirements and Working Conditions

• This position is a field-based and onsite position and requires traveling in Connecticut depending on assignments or projects.
• The national target pay range for this role is: $70,000.00 - $81,000.00. Actual compensation will be determined based on geographic location…