Medicaid & ACA Manager

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🌪️ Kansas, Missouri – Remote

🌪️ Kansas – Remote 🏰 Missouri – Remote

💵 $101.5k - $120.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Blue Cross and Blue Shield of Kansas

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

Blue Cross and Blue Shield of Kansas is the largest health insurer in the state of Kansas and operates as a mutual insurance company owned by its policyholders. Governed by a board consisting of 16 Kansans with diverse expertise, the company ensures that the voices of customers and healthcare professionals are included in its operations. With a strong financial foundation, BCBSKS pays over $1 billion in annual claims to healthcare providers and actively contributes more than $140 million to the local economy through payroll and taxes. Headquartered in Topeka, KS, it employs nearly 1,400 individuals across various locations in the state and is part of the Blue Cross Blue Shield Association, which facilitates collaboration among 36 independent Plans nationwide.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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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