Medicaid & ACA Manager

Blue Cross and Blue Shield of Kansas•Topeka, MO

1d•$101,520 - $120,500

About The Position

The Manager, Medicaid & ACA supports the strategic and operational execution of Medicaid and Affordable Care Act (ACA) programs, including individual and small group markets. Working closely with the Director, this role translates strategy into disciplined execution and provides operational, analytical, and coordination leadership. The position monitors performance, generates insights, coordinates across functions, and oversees execution of initiatives affecting medical cost, revenue, regulatory compliance, and member outcomes, particularly in ACA Individual and Small Group Markets. The position may be performed remotely, hybrid, or onsite in accordance with the company’s Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment. No travel is required.

Requirements

High school diploma or equivalent required.
Minimum 5 years of experience working with Medicaid programs and/or ACA/Individual Marketplace required.
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 skills.
High attention to detail and 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 government programs, CMS, and ACA Marketplace operations and strategy.
Strong understanding of health plan operations, MLR drivers and cost-management levers, and ACA regulatory requirements.
In lieu of a degree, an additional 5 years of relevant experience is required.

Nice To Haves

Bachelor's degree or equivalent in business administration, health care, public health, or a related field.
Master's degree (MBA, MPH, MHA, or equivalent).
Minimum 3 years of experience supervising individuals.
Experience supporting executive leadership and preparing materials for senior leadership or boards.

Responsibilities

Build and manage detailed workplans, timelines, milestones, and accountability structures across the portfolio.
Oversee day-to-day execution of initiatives, ensuring alignment with financial, operational, and regulatory objectives.
Monitor and interpret ACA performance indicators, including MLR, risk adjustment and coding capture, enrollment trends, utilization, and cost drivers.
Support ACA-specific analyses related to morbidity shifts, affordability, and benefit design.
Identify trends, risks, and opportunities and 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; and drive accountability and alignment with organizational goals.
Support regulatory and compliance readiness, including ACA reporting and submissions, audit preparation, regulatory inquiries, and corrective action planning and tracking.
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.