Director ACA & Medicaid
Blue Cross Blue Shield Kansas

The position is accountable to the Associate Vice President of Government Programs for the operational and strategic components of our Individual Marketplace product line as well as the oversight of our Medicaid partnership, Healthy Blue. This position must have a breadth of knowledge related to product development, sales, operations, medical management, vendor management and compliance to maintain successful CMS programs. Responsible for the oversight and ongoing strategic direction for our Individual Marketplace products, including operational success, vendor oversight, revenue management, and ensuring compliance with all government requirements.
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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.

Why Join Us?
• Make a Positive Impact: Your work will directly contribute to the health and well-being of Kansans.
• Lead and Inspire: Guide and mentor your team to achieve their full potential and success.
• Family Comes First: Total rewards package that promotes the idea of family first for all employees.
• Professional Growth Opportunities: Advance your career with ongoing training and development programs.
• Dynamic Work Environment: Collaborate with a team of passionate and driven individuals.
• Trust: Work for one of the most trusted companies in Kansas
• Stability: 80 years of commitment, compassion and community
• Flexibility: options to work onsite, hybrid or remote available
• Balance: paid vacation and sick leave with paid maternity and paternity available immediately upon hire
• Inclusive Work Environment: We pride ourselves on fostering a diverse and inclusive workplace where everyone is valued and respected.
• Innovative Technology:

Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas.

What you'll do:

• Participate in development of the overall strategy for the Individual Marketplace line of business, including the product and bid development and reconciliation processes.
• Responsible for overseeing the Individual line of business operations, including CMS submissions and attestations, vendor management, and coordinating efforts with internal functions such as Sales, Marketing, Provider Relations, Finance and Compliance.
• Oversee the financial business case to support product growth, operational excellence and compliance for Individual Marketplace products.
• Direct liaison with Federal regulators, ensuring compliance with all CMS rules and regulations in the ongoing operations of Individual Marketplace.
• Oversees and monitors the implementation of new CMS contractual and policy requirements, new legislation and regulations.
• Monitor and analyze the changing government landscapes and recommended programs and policies to proactively address the changing needs of our membership.
• Builds strong collaborative relationships both internally and with external partners, including CMS officials, to drive program success and address challenges where presented.
• Key point of contact for the Healthy Blue alliance and member of the Healthy Blue Joint Operating Committee.
• Oversees the operational performance of Healthy Blue and provides regular updates internally on the overall health and status of the program.
• May involve preparation of presentations and materials for professional partnering meetings, seminars, conferences, the Steering Committee and the Board.

What you need:

• Bachelor's degree, preferably in Business Administration, Economics or Public Health. In lieu of a degree, 8 years in the health care delivery industry.
• Previous Blue Plan related experience preferred.
• Experienced in strategic management and leadership directing substantial resources required

Bonus if you have:

• A thorough understanding of the Individual Marketplace program.
• Experience working and building relationships with governmental agencies.
• Demonstrated track record of leading and delegating to a team with accountability and successful achievement of financial results.
• A strong operational mindset and business acumen that adds recognizable value on matters related to the vision and strategy of the organization.
• Able to quickly shift strategies based on evolving market conditions. Responds to complicated challenges with speed and accuracy by presenting unique alternatives that mitigate risk and create competitive advantages.
• Comfortable leading in a highly matrixed, cross functional organization.

Posting Close Date

Pay Rate Type
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