Health Plan Operations Manager

TruHealth•Indianapolis, IN

About The Position

American Health Plans, a division of American Health Partners Inc., owns and operates Institutional Special Needs Plans (I-SNPs) for seniors living in long-term care facilities. In partnership with nursing home operators, its Medicare Advantage plans manage medical risk by improving patient care, reducing emergency room visits, and avoiding preventable hospitalizations. The division operates in multiple states and plans to expand into additional states in 2026. The Health Plan Operations Manager implements the Participating SNF Engagement strategy and builds collaborative relationships with partner facilities to support health plan goals. The role works across internal health-plan functions and with facility stakeholders to support implementation, facility engagement, enrollment, and improved member outcomes. The manager tracks and communicates implementation progress, identifies barriers, facilitates solutions, and ensures implementation projects are delivered on schedule, within budget, and with superior quality. The position must adhere to all compliance requirements.

Requirements

At least 3 years of experience in a healthcare or managed care organization, with increasing responsibility and accountability, including leading and facilitating teams.
Experience with value-based and risk-based negotiating arrangements.
Demonstrated success building relationships with external executives and stakeholders.
Strong ability to persuade.

Nice To Haves

Experience with Medicare Advantage or Institutional Special Needs Plans is highly preferred.
At least 5 years in the healthcare industry with experience in Medicare, Medicaid Managed Care, health insurance, or the nursing home industry.
At least 3 years of experience working with or in nursing homes.

Responsibilities

Implement and execute the Participating SNF Engagement strategy and establish collaborative relationships with partner facilities.
Work cross-organizationally with the local health plan team, Network, Market Medical Director, and Marketing as needed.
Achieve facility-level engagement goals.
Collaborate with health-plan functions including Product, Sales, Marketing, Member Experience, Finance, Network, Clinical, Quality, Operations, and local care delivery and care management.
Develop facility relationships and solutions that support the plan’s Model of Care, reduce total cost of care, and improve members’ health and healthcare experience.
Communicate key performance indicators to participating facilities.
Identify facility challenges and barriers to desired outcomes and facilitate results-driven solutions.
Manage cross-functional communication, activities, and events for facility implementation projects, ensuring delivery on schedule, within budget, and with superior quality.
Ensure appropriate cross-functional resources are involved throughout facility implementation.
Understand clients’ business needs, culture, and workflows, and use knowledge of AHP products and services to support business decisions.
Communicate business objectives and technical implementation complexities to stakeholders at all levels of AHP and client organizations.
Track, report, and communicate implementation progress; maintain the implementation data repository and keep documentation current and accessible.
Create mitigation plans during implementation to maximize enrollment.
Provide transparency on project status and delivery to AHP and client stakeholders.
Share customer feedback with Business Development, Network, Sales, Operations, Clinical, Local Market, and other internal teams regarding implementation requests and product enhancements.
Adhere to all compliance requirements.