Medicaid & ACA Manager

This is a fully remote position, open to applicants in Kansas, +1 more state.

📋 Description

• Develop and oversee comprehensive workplans, timelines, milestones, and accountability frameworks across the portfolio.

• Manage the daily execution of initiatives that align with financial, operational, and regulatory goals.

• Analyze and interpret ACA performance metrics, including MLR, risk adjustment/coding capture, enrollment trends, utilization, and cost drivers.

• Assist in ACA analyses related to morbidity shifts, affordability, and benefit design.

• Recognize trends, risks, and opportunities, translating insights into actionable recommendations.

• Direct cross-functional collaboration among Actuarial/Finance, Care & UM, Provider Networks, Risk Adjustment, Operations, and Compliance/Regulatory Affairs.

• Organize working sessions, manage dependencies, and monitor decisions, risks, and deliverables.

• Aid in regulatory and compliance preparation, including ACA reporting/submissions, audit readiness, regulatory inquiries, and corrective action planning/tracking.

• Identify and highlight execution gaps and operational risks; monitor remediation strategies, outcomes, and progress updates.

• Create executive-level materials, performance summaries, and decision-support analyses for senior management.

• Collaborate with the Director to transform strategy into effective execution for Medicaid and ACA programs.

⛳️ Requirements

• High school diploma or equivalent is mandatory.

• A Bachelor's degree or equivalent in business administration, healthcare, public health, or a related field is preferred.

• A Master's degree (MBA, MPH, MHA, or equivalent) is preferred.

• Alternatively, an additional 5 years of relevant experience is required in lieu of a degree.

• At least 5 years of experience working with Medicaid programs and/or ACA/Individual Marketplace is required.

• A minimum of 3 years of experience supervising individuals is preferred.

• Previous experience providing support to executive leadership and preparing materials for senior leadership or boards is preferred.

• Strong analytical, critical thinking, and problem-solving abilities are required.

• Capability to distill complex information into clear, actionable insights is required.

• Excellent written and verbal communication skills, including the ability to present at an executive level, are required.

• High attention to detail with the ability to link tactical execution to strategic objectives is required.

• Ability to juggle competing priorities in a fast-paced, high-pressure environment is required.

• A collaborative leadership style with confidence and executive presence is required.

• Knowledge of government programs, CMS, and ACA Marketplace operations and strategies is required.

• Strong comprehension of health plan operations, MLR drivers, cost management tools, and ACA regulatory requirements is required.

• Applicants must either reside in Kansas or Missouri or be willing to relocate as a condition of employment.

• Pre-employment drug screening, background checks, employment verifications, and education verification will be part of a conditional offer.

🏝️ Benefits

• Incentive pay program (EPIP).

• Health, Vision, and Dental insurance.

• 6 weeks of paid parental leave for new mothers and fathers.

• Assistance with Fertility and Adoption.

• 2 weeks of paid caregiver leave.

• 401(k) plan with matching up to 5%.

• Tuition reimbursement.

• Health and fitness benefits, discounts, and resources.

• Paid vacation and sick leave.

• Paid maternity and paternity leave available immediately upon hire.

• Continuous training and development programs.

• Flexible work environment.