Medicaid & ACA Manager
Pittsburg, KS
Full-time
Hybrid
1 month ago
About the role
This job was posted by https://www.kansasworks.com : For more
information, please see: https://www.kansasworks.com/jobs/13573533 Are
you ready to make a difference? Choose to work for one of the most
trusted companies in Kansas.
You Belong At Blue
the health and well-being of Kansans.
idea of family first for all employees. Paid vacation and sick leave
with paid maternity and paternity available immediately upon hire
ongoing training and development programs.
and driven individuals in a work environment that promotes
flexibility.
in Kansas with over 80 years of commitment, compassion and
community.
workplace where everyone is valued and respected.
Benefits & Perks
Rewards package
Job Summary
The Medicaid & ACA Manager supports the strategic and operational
execution of Medicaid and Affordable Care Act (ACA) programs (individual
and small group), serving as a critical operational, analytical, and
coordination leader while partnering closely with the Director to
translate strategy into disciplined execution. This role is responsible
for performance monitoring, insight generation, cross-functional
coordination, and execution oversight. The role ensures initiatives
impacting medical cost, revenue, regulatory compliance, and member
outcomes are effectively planned, executed, and monitored particularly
within the ACA Individual and Small Group Markets.
This position is eligible to work remotely, hybrid, or onsite in
accordance with our Telecommuting Policy. Applicants must reside in
Kansas or Missouri or be willing to relocate as a condition of
employment.
What you\'ll do
accountability structures across the portfolio
financial, operational, and regulatory objectives
risk adjustment/coding capture, enrollment trends, utilization and
cost drivers) and support ACA specific analyses related to morbidity
shifts, affordability, benefit design, etc.
support leadership decision-making
actionable recommendations and execution support
UM, Provider Networks, Operations, and Compliance/Regulatory Affairs
risks, and deliverables to drive accountability and ensure
initiatives remain aligned with organizational goals
reporting/submissions, audit prep, regulatory inquiries, and
corrective action planning/tracking)
risks, track remediation plans, outcomes, and progress reporting
decision-support analyses for senior leaders
Knowledge/Skills/Abilities
insights
executive-level presentation
execution to strategic goals
environment
presence
Marketplace operations
management levers and Medicaid and ACA regulatory requirements
What you need
Education And Experience
care, public health or related field, required. Master\'s degree
(MBA, MPH, MHA, or equivalent), preferred
Minimum five (5) years\' experience working with Medicaid
information, please see: https://www.kansasworks.com/jobs/13573533 Are
you ready to make a difference? Choose to work for one of the most
trusted companies in Kansas.
You Belong At Blue
- Why Join Us?
- Make a Positive Impact: Your work will directly contribute to
the health and well-being of Kansans.
- Family Comes First: Total rewards package that promotes the
idea of family first for all employees. Paid vacation and sick leave
with paid maternity and paternity available immediately upon hire
- Professional Growth Opportunities: Advance your career with
ongoing training and development programs.
- Dynamic Work Environment: Collaborate with a team of passionate
and driven individuals in a work environment that promotes
flexibility.
- Trust and Stability: Work for one of the most trusted companies
in Kansas with over 80 years of commitment, compassion and
community.
- Inclusive Work Environment: We pride ourselves on fostering a
workplace where everyone is valued and respected.
Benefits & Perks
- Base compensation is only one component of your competitive Total
Rewards package
- 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
Job Summary
The Medicaid & ACA Manager supports the strategic and operational
execution of Medicaid and Affordable Care Act (ACA) programs (individual
and small group), serving as a critical operational, analytical, and
coordination leader while partnering closely with the Director to
translate strategy into disciplined execution. This role is responsible
for performance monitoring, insight generation, cross-functional
coordination, and execution oversight. The role ensures initiatives
impacting medical cost, revenue, regulatory compliance, and member
outcomes are effectively planned, executed, and monitored particularly
within the ACA Individual and Small Group Markets.
This position is eligible to work remotely, hybrid, or onsite in
accordance with our Telecommuting Policy. Applicants must reside in
Kansas or Missouri or be willing to relocate as a condition of
employment.
What you\'ll do
- Build and manage detailed workplans, timelines, milestones, and
accountability structures across the portfolio
- Oversee day-to-day execution of initiatives, ensuring alignment to
financial, operational, and regulatory objectives
- Monitor and interpret key ACA performance indicators (e.g., MLR,
risk adjustment/coding capture, enrollment trends, utilization and
cost drivers) and support ACA specific analyses related to morbidity
shifts, affordability, benefit design, etc.
- Develop and maintain dashboards and recurring performance reports to
support leadership decision-making
- Identify trends, risks, and opportunities; convert insights into
actionable recommendations and execution support
- Lead cross-functional coordination across Actuarial/Finance, Care &
UM, Provider Networks, Operations, and Compliance/Regulatory Affairs
- Facilitate working sessions, manage dependencies, track decisions,
risks, and deliverables to drive accountability and ensure
initiatives remain aligned with organizational goals
- Support regulatory and compliance readiness (ACA
reporting/submissions, audit prep, regulatory inquiries, and
corrective action planning/tracking)
- Proactively identify and escalate execution gaps and operational
risks, track remediation plans, outcomes, and progress reporting
- Prepare executive-rea y materials, performance summaries, and
decision-support analyses for senior leaders
Knowledge/Skills/Abilities
- Strong analytical, critical thinking, and problem-solving skills
- Ability to synthesize complex information into clear, actionable
insights
- Excellent written and verbal communication skills, including
executive-level presentation
- High attention to detail with the ability to connect tactical
execution to strategic goals
- Ability to manage competing priorities in a fast-paced, high-stakes
environment
- Collaborative leadership style with confidence and executive
presence
- Knowledge of state Medicaid contracts, CMS guidance, and ACA
Marketplace operations
- Strong understanding of health plan operations, MLR drivers and cost
management levers and Medicaid and ACA regulatory requirements
What you need
Education And Experience
- Bachelor\'s degree or equivalent in business administration, health
care, public health or related field, required. Master\'s degree
(MBA, MPH, MHA, or equivalent), preferred
Minimum five (5) years\' experience working with Medicaid
Skills
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