Risk & Compliance (1)

Alignment 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 Senior Director, Delegate Oversight is an enterprise leader accountable for the vision, strategy, and performance of Alignment Healthcare’s delegated oversight function. This role elevates oversight from a pro-grammatic and compliance-focused function to a strategic, enterprise capability that drives value-based performance, mitigates risk, and enables growth across the delegated network.
With end-to-end accountability for First Tier, Downstream, and Related (FDR) entities, the Senior Director ensures that delegated partners (IPAs, MSOs, and others) consistently deliver against clinical, operational, financial, and regulatory expectations. This leader operates with significant autonomy and executive visibility, shaping how delegated performance is governed, measured, and improved across the organization.
The Senior Director serves as the primary executive partner to internal leadership and external delegated entities, aligning incentives, driving accountability, and ensuring performance outcomes that support enterprise priorities. This role requires a strategic, data-driven leader with deep expertise in value-based care and the ability to influence at the highest levels of the organization.

Job Duties/Responsibilities:

Enterprise Ownership of Delegate Oversight

Own and evolve the enterprise delegated oversight strategy, ensuring alignment with corporate objectives, regulatory requirements, and value-based care priorities.
Establish a holistic performance framework that integrates clinical, operational, financial, and compliance metrics across all delegated entities.
Maintain accountability for delegated performance outcomes, including quality, utilization, risk adjustment, member experience, and cost of care.
Ensure oversight models are scalable and adaptable to support organizational growth and increasing complexity in risk-bearing arrangements.

Governance, Risk & Performance Accountability

Define and lead enterprise governance structures that proactively identify, assess, and mitigate risks across the delegated network.
Oversee risk stratification methodologies, performance scoring, and audit frameworks to ensure consistency, rigor, and regulatory alignment.
Act as the senior escalation point for performance and compliance risks, ensuring timely intervention and resolution of issues with enterprise impact.
Provide regular, transparent reporting to executive leadership on delegated performance, risks, and mitigation strategies.

Executive Partnership & External Leadership

Serve as the lead relationship owner for delegated partner executives, driving alignment on performance expectations and long-term strategy.
Facilitate executive-level performance reviews with IPAs and MSOs, ensuring accountability and measurable improvement.
Influence internal executive stakeholders by translating performance insights into strategic recommendations and action plans.
Represent delegated oversight in enterprise initiatives, regulatory readiness efforts, and cross-functional planning.

Performance Enablement & Continuous Improvement

Drive the evolution of delegated oversight into a proactive, insight-driven function, leveraging analytics to identify opportunities and intervene early.
Lead cross-functional collaboration with Clinical, Quality, Compliance, Network, and Operations teams to improve delegated outcomes.
Promote standardization, best practice sharing, and continuous improvement across the delegated network.
Ensure tools, reporting, and processes enable effective performance management and decision-making.

Leadership & Team Development

Lead and develop a high-performing team, setting clear expectations and fostering a culture of accountability and continuous improvement.
Provide direction and oversight across analytics, audit, and performance management activities within the function.
Influence and align matrixed teams to drive enterprise performance goals.

Supervisory Responsibilities:

Direct oversight of team members supporting delegated oversight, including performance, audit, and analytics functions. Matrix leadership across cross-functional stakeholders involved in delegated performance.

Job Requirements:

Experience:

10–12+ years of experience in healthcare operations, delegated oversight, provider network management, or value-based care.
5+ years of leadership with delegation oversight specifically, compliance or provider performance
5+ years of leadership experience with accountability for performance outcomes.
Experience developing and executing performance management strategies across clinical, operational, and compliance domains.
Demonstrated ability to influence senior stakeholders and manage external partner relationships.
Strong understanding of healthcare regulatory frameworks (CMS, DMHC, DHCS, NCQA) and delegated models.
Experience working in matrixed organizations and driving cross-functional initiatives.

Education:

Bachelor’s degree required in Healthcare Administration, Public Health, Business Administration, Nursing, or a related field.
Master’s degree strongly preferred (e.g., MHA, MPH, MBA, MSN) with a focus in healthcare management, policy, or operations.
Advanced training or certification in value-based care, population health, healthcare compliance (e.g., CHC, CPCO), or project management (e.g., PMP) is a plus.

Training:

• Required: N/A

• Preferred: Lean/Six Sigma

Specialized Skills:

• Required:

Strong strategic thinking with the ability to translate into execution.
Analytical mindset with experience using data to drive decisions and performance improvement.
Excellent communication and stakeholder management skills.
Ability to manage ambiguity and balance multiple priorities.
Collaborative leadership style with the ability to influence without authority.

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: $130,332.00 - $195,498.00

Pay 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.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].

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