Medicaid & ACA Manager

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🕒 Ontem

🌪️ Kansas, Missouri – Remoto

🌪️ Kansas – Remote 🏰 Missouri – Remote

💵 $101.520 - $120.500 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

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Blue Cross and Blue Shield of Kansas

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

🏥 Saúde

💼 Consultoria

⚕️ Seguro de Saúde

Healthcare • Consulting • Healthcare Insurance

A maior seguradora de saúde do estado de Kansas. Como uma companhia de seguros mútuos, a BCBSKS pertence aos seus segurados. Seu conselho de administração é composto por cidadãos do Kansas de diferentes regiões do estado, sendo 16 deles segurados que trazem para a mesa experiências práticas em negócios, medicina, administração hospitalar e educação. As operações diárias são dirigidas por um comitê de direção de nove pessoas sob a orientação do presidente/CEO da empresa. Clientes e profissionais de saúde têm voz nas atividades da empresa por meio de vários comitês consultivos e de ligação, bem como grupos focais e pesquisas.

Descrição

• Build and manage detailed workplans, timelines, milestones, and accountability structures across the portfolio • Oversee day-to-day execution of initiatives aligned with financial, operational, and regulatory objectives • Monitor and interpret ACA performance indicators, including MLR, risk adjustment/coding capture, enrollment trends, utilization, and cost drivers • Support ACA analyses related to morbidity shifts, affordability, and benefit design • Identify trends, risks, and opportunities and convert insights into actionable recommendations • Lead cross-functional coordination across Actuarial/Finance, Care & UM, Provider Networks, Risk Adjustment, Operations, and Compliance/Regulatory Affairs • Facilitate working sessions, manage dependencies, and track decisions, risks, and deliverables • Support regulatory and compliance readiness, including ACA reporting/submissions, audit preparation, regulatory inquiries, and corrective action planning/tracking • Identify and escalate execution gaps and operational risks; track remediation plans, outcomes, and progress reporting • Prepare executive-ready materials, performance summaries, and decision-support analyses for senior leaders • Partner with the Director to translate strategy into disciplined execution for Medicaid and ACA programs

🎯 Requisitos

• High school diploma or equivalent required • Bachelor's degree or equivalent in business administration, health care, public health or related field preferred • Master's degree (MBA, MPH, MHA, or equivalent) preferred • In lieu of degree, an additional 5 years of relevant experience required • Minimum 5 years' experience working with Medicaid programs and/or ACA/Individual Marketplace required • Minimum 3 years' experience supervising individuals preferred • Previous experience supporting executive leadership and preparing materials for senior leadership or boards preferred • Strong analytical, critical thinking, and problem-solving skills required • Ability to synthesize complex information into clear, actionable insights required • Excellent written and verbal communication skills, including executive-level presentation required • High attention to detail with the ability to connect tactical execution to strategic goals required • Ability to manage competing priorities in a fast-paced, high-stakes environment required • Collaborative leadership style with confidence and executive presence required • Knowledge of government programs, CMS, and ACA Marketplace operations and strategy required • Strong understanding of health plan operations, MLR drivers and cost management levers and ACA regulatory requirements required • Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment • Pre-employment drug screening, criminal conviction check, employment verifications and education verification as part of a conditional offer

🏖️ Benefícios

• Incentive pay program (EPIP) • Health/Vision/Dental insurance • 6 weeks paid parental leave for new mothers and fathers • Fertility/Adoption assistance • 2 weeks paid caregiver leave • 401(k) plan matching up to 5% • Tuition reimbursement • Health & fitness benefits, discounts and resources • Paid vacation and sick leave • Paid maternity and paternity leave available immediately upon hire • Ongoing training and development programs • Flexible work environment

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