Market Operations Specialist

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

What Youll Do

• 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.

• 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 escalate issues with actionable recommendations.

• 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.

• 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 workgroups to ensure aligned execution accountability and follow-through across departments.

• 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

• Bachelors 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.

• 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: $70000.00 - $81000.00. Actual compensation will be determined based on geographic location (current or future) experience and other job-related factors.