Medicaid & ACA Manager

Blue Cross Blue Shield of Kansas • Lawrence, KS • 3h ago

This job was posted by https://www.kansasworks.com : For more information, please see: https://www.kansasworks.com/jobs/13585185 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-ready 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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