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.

Primary Duties
Data Triage and Operations

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Identify, triage, route, and resolve data quality issues across Aledade’s 1,200+ payer data feeds.

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Partner with payers and internal teams to address broken SFTP connections, delivery delays, and file transmission failures.

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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.

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Maintain accurate contract metadata (i.e. contract names, TINs, and administrative details) to ensure seamless downstream data integration into reporting and product platforms.

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Investigate and resolve manual care gap upload failures to ensure complete and accurate data ingestion.

Cross-Functional Collaboration

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Collaborate with internal teams—including Payer Solutions, Product, Engineering, and Field Operations—and payer partners to intake, investigate, route, and resolve data issues.

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Communicate complex data findings and technical concepts clearly to diverse technical and non-technical stakeholders.

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Lead cross-functional data initiatives from discovery through implementation by mapping workflows, facilitating alignment, delivering actionable recommendations, and establishing clear task ownership and deliverables.

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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

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Maintain standard operating procedures (SOPs) for data issue triage, clinical ingestion troubleshooting, and Primary Source Verification (PSV) audits.

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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
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Bachelor’s Degree

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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.

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Intermediate SQL programming experience.

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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).

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Demonstrated ability to navigate complex data environments and trace data flows across internal and external systems to identify root causes.

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Proven track record of collaborating in cross-functional teams with the ability to effectively communicate technical insights and business impact to diverse stakeholders.

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