Medicare and ACA Implementation Manager- Health Plans

Careers With Purpose

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland.

Facility: Remote SD (Central Time) Location: Remote, SD Address: Shift: 8 Hours - Day Shifts Job Schedule: Full time Weekly Hours: 40.00 Salary Range: $32.50 - $52.00

Department Details

Drive healthcare innovation from strategy to implementation. Join a team where your leadership, problem-solving skills, and ability to bring people together will directly shape the future of health plan products and member experiences. This is a high Impact and highly visible role. Work remotely while collaborating with departments across the organization. Continue to build expertise in regulatory, operational, and strategic aspects of health insurance.

Job Summary

The Implementation Manager will play a critical role in bringing products and services from design to market. This individual will serve as the leader for the successful implementation of key Health Plan initiatives and product execution. The Implementation Manager will develop and manage implementation strategies, understands internal and external requirements, develops and manage project plans to enable end-to-end implementation of products and initiatives in collaboration with business and technology teams. This individual will lead cross-functional implementation activities, execution, and alignment/synergies, and understands business and technical details of execution according to stringent deadlines. The Implementation Manager must be able to indirectly lead cross-functional teams and is responsible for fostering a culture of service excellence and continuous improvement. Translates product documentation into business requirements that ensure products and services meet the needs of the market. Leads cross-functional teams to create Implementation plans and appropriate documentation for product or project rollouts. Collaborates with all departments to assist in supporting tactical tasks, implementation, and administration for government program product lines. Communicates project and initiative implementation status, key objectives, success metrics and any risks/issues effectively throughout the organization.

Assesses project issues and leads the team to develop resolutions to meet goals and objectives. Maintains current knowledge of the regulatory environment that impacts existing and new products to ensure compliance with external state and federal regulators. Manages complex concurrent projects and vendor relations to support and accomplish the goals and objectives of the organization.

Coordinates with government programs to submit product filings and applicable product reporting to governmental agencies. Understands business requirements and identifies internal resources needed to respond to government agency requests, implement new guidance and/or assist in developing or streamlining internal processes. Serves as the conduit between applicable governmental agencies, internal departments, and subcontracted agencies to ensure timely and accurate dissemination of product requirements and lead their implementation. Coordinates and/or monitors timely required reporting and filings to meet contract requirements.

Applies knowledge and experience of Medicare Advantage, Affordable Care Act (ACA), and commercial health insurance products to support daily operations and business objectives.

Qualifications

Bachelor’s Degree in Business, Marketing, or Healthcare related field

3 years experience in health insurance industry or related field required.

Experience working within Health Plan and/or project management experience, preferred.

Certified Associate in Project Management (CAPM), preferred.

Benefits

Sanford offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits .

Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to [email protected] .

Sanford has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.

Req Number: R-0274533 Job Function: Health Plan Featured: No