United States onlyAlignment 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, Delegate Performance is a key leadership role within Alignment Healthcare’s evolving Delegate Oversight organization, responsible for translating oversight results into actionable performance management strategies for delegated entities. Reporting to the Director of Delegate Oversight, this role supports the trans-formation of the function from a historically compliance-focused model to a proactive performance management and improvement partner.This role serves as the primary owner of ongoing performance assessment, analysis, and dialogue with dele-gated partners, leveraging inputs from audits, monitoring activities, scorecards, and operational results across claims, clinical (UM/CM/CCM), appeals, and credentialing. The Manager is responsible for synthesizing these inputs into a holistic performance narrative, identifying trends, risks, and opportunities, and driving structured performance discussions with delegates.
The Manager partners closely with internal audit, clinical, quality, compliance, and operational teams to ensure findings are operationalized into meaningful performance expectations, corrective actions, and sustained improvement. This role requires strong communication and analytical skills, operational understanding of delegated functions, and the ability to influence provider organizations through data-driven insights and collaborative performance management.
Job Duties/Responsibilities:
Delegate Performance Management & Analysis
- Own the end-to-end performance management process for assigned delegated entities, synthesizing audit results, monitoring outputs, scorecards, and operational data into a comprehensive view of delegate performance.
- Translate compliance and operational findings into actionable performance insights, clearly articulating root causes, risk implications, and improvement opportunities across claims, UM, CM/CCM, appeals, and credentialing.
- Conduct ongoing trend analysis to identify emerging performance risks, patterns, or improvement opportunities beyond discrete audit cycles.
- Develop and maintain delegate-specific performance profiles that integrate clinical, operational, and compliance dimensions.
Performance Engagement & Accountability
- Lead routine and ad hoc performance discussions with delegated partners, ensuring clear communication of expectations, performance gaps, and progress against improvement plans.
- Partner with delegates to define performance improvement actions, milestones, and success measures informed by audit and monitoring outputs.
- Monitor delegate progress against agreed-upon action plans, escalating sustained or systemic performance concerns to the Director of Delegate Oversight as appropriate.
- Serve as a consistent point of contact for delegates on performance-related matters, reinforcing accountability while fostering collaborative improvement.
Cross-Functional Collaboration & Integration
- Partner closely with DO Audit, Compliance, Clinical, Quality, and Operational teams to ensure alignment between oversight findings and performance management strategies.
- Ensure audit results and monitoring outputs are effectively operationalized and not treated as standalone compliance artifacts.
- Support enterprise initiatives related to delegated performance, including regulatory readiness, value-based care objectives, and clinical quality improvement efforts.
Reporting, Insights & Continuous Improvement
- Prepare clear, concise performance summaries and presentations for leadership, translating complex data into actionable insights.
- Contribute to the evolution of performance scorecards, metrics, and reporting tools to support a more proactive, forward-looking oversight model.
- Identify opportunities to improve performance management workflows, tools, and communication approaches as the function matures.
- Support the Director in enterprise-level performance reviews, governance forums, and strategic discussions by providing detailed performance analysis and insights.
Supervisory Responsibilities:
This role may include indirect oversight or matrix leadership of program/project managers and audit staff.
Job Requirements:
Experience:
- 6+ years of experience in healthcare operations, delegated oversight, provider performance management, or value-based care environments.
- 3+ years of experience in a performance management, oversight, analytics, or operational leadership role within a health plan, IPA, MSO, or related organization.
- Demonstrated experience interpreting audit results, monitoring outputs, or regulatory findings and translating them into operational or performance improvement actions.
- Strong understanding of delegated functions including claims, UM, CM/CCM, appeals, and credentialing.
- Proven ability to engage provider organizations or delegated partners in structured performance discussions.
- Experience working cross-functionally in matrixed healthcare organizations.
Education:
- Bachelor’s degree required in Healthcare Administration, Public Health, Business Administration, Nursing, or a related field.
- Master’s degree preferred (e.g., MHA, MPH, MBA, MSN).
Training:
• Required: N/A
• Preferred: Lean/Six Sigma or other continuous improvement methodologies
Specialized Skills:
• Required:
- Strong analytical and critical thinking skills with the ability to synthesize data from multiple oversight sources.
- Working knowledge of delegated oversight and regulatory frameworks (e.g., CMS, DMHC, DHCS, NCQA).
- Ability to communicate performance findings clearly and professionally to internal leaders and delegated partners.
- Proficiency in Excel and experience with performance reporting or data visualization tools (e.g., Tableau, Power BI preferred).
- Strong organizational skills with the ability to manage multiple delegates, priorities, and timelines.
- Collaborative, solutions-oriented mindset with comfort operating in evolving and ambiguous environments.
Other:
• Required: 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: $85,696.00 - $128,543.00Pay 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.
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