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Business Operations Lead - Individual Exchange Product job in Philadelphia at Amerihealth

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Business Operations Lead - Individual Exchange Product at Amerihealth

Business Operations Lead - Individual Exchange Product

Amerihealth Philadelphia, PA Full Time

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at [ Link removed ] - Click here to apply to Business Operations Lead - Individual Exchange Product.

This role is eligible for a sign-on bonus of $2,500


Describe the primary (most important) purpose of the job in no more than a paragraph to provide a solid overview of the essence of the job in seven sentences or less.

The Business Operations Lead reports to Mgr, Business Operations.  The Business Operations Lead is responsible for collaborating with the business functional teams (e.g., claims, medical management) to implement, support, and sustain Exchange segment business operations. The Business Operations Lead supports the execution of open enrollment activities and manages the timeline and scope of cross-functional projects and initiatives, such as process improvements, exchange infrastructure build to support new businesses, and internal and external (CMS, DIFS/OFIR) audit support. The Business Operations lead also coordinates with the business functions to measure and monitor Exchange segment financial and operational performance and conduct data analysis as needed. 

The Business Operations Lead works on topics of moderately complex scope, requiring the exercise of independent judgement (within defined practices and procedures) and the application of an intermediate level of subject matter expertise. The Business Operations Lead must be integrated with and aware of business cycles across Operations, Procurement, and Finance. The Business Operations Lead’s contributions will have an impact on cost, efficiency, and productivity of the Exchange segment. 

The Business Operations Lead works on moderately complex topics where analysis of situations or data requires evaluation of several competing factors across multiple functional areas. The Business Operations Lead coordinates the work efforts of small to medium cross-functional teams, capable of managing several tasks simultaneously within tight time frames.

Coordinates internal operational delivery:

  • Moderately complex scope in multiple geographies

Maintains stakeholder relationships:

  • Manages first to mid-level stakeholders

Coordinates cross-functional business teams:

  • Coordinates the work of full-time employees and contractors of cross-functional teams of teams of any size


  • Bachelor’s Degree.
  • Detail oriented, ability to work in “gray areas” towards a solution.
  • Strong organizational and communication skills along with the ability to communicate with all levels in the organization.
  • Demonstrated ability to learn and apply the learning in a business environment. Ability to communicate business and financial analytics and reports across disciplines and to senior executives.
  • Proven ability to work across organizations and rapidly gain / build trust with stakeholders.
  • Proficiency in Microsoft Office Word, Excel, Outlook, PowerPoint, SharePoint and Visio.
  • 3+ years of experience in business analysis, or operations management.
  • Demonstrates a strong working knowledge of key health plan business functions and capabilities, operational policies, processes, and methodologies applicable to health plan project management.
  • This position is teleworker eligible

Recommended Skills

  • Process Improvements (Business)
  • Data Analysis
  • Business Analysis
  • Microsoft Power Point
  • Operations
  • Microsoft Visio
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Job ID: 7055_22256

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