Medicaid & ACA Manager

Blue Cross and Blue Shield of Kansas•Topeka, KS

17h•Hybrid

About The Position

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.

Requirements

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
Bachelor’s degree or equivalent in business administration, health care, public health or related field, required.
Minimum five (5) years’ experience working with Medicaid programs and/or ACA/Individual Marketplace, required

Nice To Haves

Master’s degree (MBA, MPH, MHA, or equivalent), preferred
Minimum three (3) years’ experience supervising individuals preferred
Experience supporting executive leadership and preparing materials for senior leadership or boards, preferred

Responsibilities

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