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Remote Ohana Health Plan Jobs (NOW HIRING)

Aledade PBC

Sr. Health Plan Operations Analyst

$66K - $79K/yr

The Sr. Analyst, Health Plan Performance (HPP) Ops is responsible for extracting, analyzing, and ... Strong communication skills with the ability to collaborate effectively across remote teams.

Aledade PBC

Sr. Health Plan Operations Analyst

$66K - $79K/yr

The Sr. Analyst, Health Plan Performance (HPP) Ops is responsible for extracting, analyzing, and ... Strong communication skills with the ability to collaborate effectively across remote teams.

Phsorg

Work Arrangement Remote: Open to applicants in the United States, excluding IL, ND, NY, WA, and WY ... Serve as a senior liaison between the health plan and provider community.Drive continuous ...

FAVARH

This role is fully remote, with no regular in-office requirement. The Contributions You'll Make: * Manage relationships with a portfolio of Health Plan customers across all stages of the customer ...

FAVARH

This role is fully remote, with no regular in-office requirement. The Contributions You'll Make: * Manage relationships with a portfolio of Health Plan customers across all stages of the customer ...

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What is the difference between Remote Ohana Health Plan vs Remote Healthcare Customer Service Representative?

AspectRemote Ohana Health PlanRemote Healthcare Customer Service Representative
Required CredentialsHealth insurance knowledge, customer service experience, possibly health-related certificationsCustomer service skills, healthcare knowledge often preferred, no specific certifications required
Work EnvironmentRemote, healthcare insurance settingRemote, healthcare or insurance customer support
Employer & Industry UsageHealth insurance providers, Medicaid plansHealthcare providers, insurance companies, health plans
Search & Comparison IntentUnderstanding roles within health insurance companiesCustomer support roles in healthcare industry

Remote Ohana Health Plan primarily employs roles focused on health insurance administration and member support, requiring specific industry knowledge and certifications. Remote Healthcare Customer Service Representatives also work remotely in healthcare settings but focus more on customer support without necessarily requiring specialized certifications. Both roles serve the healthcare industry but differ in their specific responsibilities and credential requirements.

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Remote Ohana Health Plan jobs near you
Infographic showing various Remote Ohana Health Plan job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 17% Part Time, and 5% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution.

Sr. Health Plan Operations Analyst

Aledade PBC

Remote

$66K - $79K/yr

Full-time

Medical, Retirement

Re-posted 16 days ago

Job description

The Sr. Analyst, Health Plan Performance (HPP) Ops is responsible for extracting, analyzing, and transforming complex health plan data into actionable strategic insights. This role drives dashboard creation, leads rigorous quality assurance auditing, and provides cross-functional leadership and mentorship to optimize value-based care contract performance.
Primary Duties
Dashboard Creation & Analytical Design
  • Design, build and maintain dashboards, productivity trackers, and KPIs utilized by leadership to improve market performance and daily operations.
  • Build high-complexity queries of back-end data to power dashboards and custom ad-hoc projects.
  • Present data findings clearly through visualization tools to ensure understanding among diverse stakeholders and colleagues.
  • Incorporate industry benchmarks into visual metrics (charts, graphs, pivot tables) to show baseline and current states.
  • Identify, monitor, and communicate changes or trends in quality and spend metrics.

Auditing & Quality Assurance
  • Act as the first line of defense investigating, triaging, documenting, and resolving internal and external data quality issues.
  • Create and apply testing algorithms to evaluate large data streams throughout the system data flow.
  • Audit year-end performance and claims data for discrepancies, reporting errors to payer teams for swift resolution.

Day-to-Day Operations
  • Source, clean, and organize data from multiple streams (payer portals, Rx claims files, SFTP sites, and internal databases).
  • Execute advanced SQL queries in Snowflake to supplement payer data for analysis and reporting QA.
  • Develop complex formulas and templates in Google Sheets and Excel to streamline repetitive data tasks.
  • Maintain comprehensive documentation regarding operational analytics, source-of-truth architectures, and peer cross-coverage plans.

Leadership Support
  • Assist the manager with work coordination, mentoring junior analysts, developing training plans, and reviewing team work products.
  • Serve as a data subject matter expert (SME); attend meetings in the manager's absence.
  • Facilitate clear intradepartmental and cross-functional communication among key stakeholders.

Other duties as assigned
Minimum Qualifications
  • Bachelor's degree in a related quantitative field or equivalent professional experience.
  • 4+ years of experience with data management, analysis, QA, and auditing healthcare or payer data.
  • Intermediate SQL programming experience (Snowflake preferred).
  • Advanced Microsoft Excel / Google Sheets skills (complex formulas, nested functions, pivot tables).
  • Strong communication skills with the ability to collaborate effectively across remote teams.
  • Proactive mindset with a proven ability to prioritize multiple tasks in a fast-paced environment.

Preferred Qualifications
  • Understanding of value-based care/Alternative Payment Models, Medicare, and Non-MSSP quality measures
  • Experience with statistical software, such as R or Stata

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

$66,000 - $79,000 a year
This range represents the expected base pay for the role across all U.S. locations, based on market data and internal benchmarking. Aledade offers a competitive total rewards package, which includes a company bonus, equity, 401k match, healthcare coverage and a broad range of other benefits. A full review of our total rewards package will be discussed at the offer stage with the selected candidate.
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We may use automated tools, including artificial intelligence (AI), to help organize and evaluate application materials. These tools support our recruiters and hiring managers by helping manage large applicant pools. Human judgment plays an essential role in our hiring process, including in the oversight and use of any automated tools. If you would like more information about our screening and hiring process, please contact us.Our Commitment to Authenticity. We use Endorsed, a fraud detection tool, to validate the authenticity of applications and protect against identity fraud. This ensures we are connecting with real people and allows us to prioritize genuine candidates.When you apply to a job on this site, the personal data contained in your application will be collected by Aledade PBC using Lever, a cloud services provider located in the United States. Lever is engaged by Aledade PBC to help manage its recruitment and hiring processes. For more information about how your personal data will be processed by Aledade PBC and any rights you may have, please review Aledade PBC's Candidate Privacy Notice. By applying for this job, you agree to Aledade's Applicant Privacy Policy available at https://www.aledade.com/privacy-policy-applicantsIf you have any questions about our privacy practices, please contact [email protected].

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