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Medicaid & ACA Manager

Blue Cross Blue Shield of Kansas

Topeka, KS

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JOB DETAILS
SKILLS
Actuarial Skills, Analysis Skills, Business Administration, Centers for Medicare and Medicaid Services (CMS), Communication Skills, Corrective Action, Cost Control, Cross-Functional, Decision Support, Detail Oriented, Finance, Financial Operations, Health Plan, Leadership, Medicaid, Monitor Regulations, Operations Planning, Performance Analysis, Performance Metrics, Presentation/Verbal Skills, Problem Solving Skills, Progress Reports, Public Health, Regulations, Regulatory Compliance, Regulatory Requirements, Reporting Dashboards, Risk, Risk Analysis, Team Player, Trend Analysis, Writing Skills
LOCATION
Topeka, KS
POSTED
8 days ago
This job was posted by https://www.kansasworks.com : For more information, please see: https://www.kansasworks.com/jobs/13596299 **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

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Blue Cross Blue Shield of Kansas