Job SummaryThe Manager, Medicaid & ACA 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.
Work Location: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.
- Identify trends, risks, and opportunities; convert insights into actionable recommendations and execution support
- Lead cross-functional coordination across Actuarial/Finance, Care & UM, Provider Networks, Risk Adjustment, 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
What you'll needEducation- High school diploma or equivalent required
- Bachelor's degree or equivalent in business administration, health care, public health or related field preferred
- Master's degree (MBA, MPH, MHA, or equivalent) preferred
- In lieu of degree, an additional 5 years of relevant experience required
Experience- Minimum 5 years' experience working with Medicaid programs and/or ACA/Individual Marketplace required
- Minimum 3 years' experience supervising individuals preferred
- Previous experience supporting executive leadership and preparing materials for senior leadership or boards preferred
TravelKnowledge, Skills and Abilities- Strong analytical, critical thinking, and problem-solving skills required.
- Ability to synthesize complex information into clear, actionable insights required.
- Excellent written and verbal communication skills, including executive-level presentation required.
- High attention to detail with the ability to connect tactical execution to strategic goals required.
- Ability to manage competing priorities in a fast-paced, high-stakes environment required.
- Collaborative leadership style with confidence and executive presence required.
- Knowledge of government programs, CMS, and ACA Marketplace operations and strategy required.
- Strong understanding of health plan operations, MLR drivers and cost management levers and ACA regulatory requirements required.
Compensation$101,520 - $120,500
Exempt Grade 17
- Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts.
