Medicare and ACA Implementation Manager- Health Plans

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.





Work Shift:

8 Hours - Day Shifts (United States of America)



Scheduled Weekly Hours:

40



Compensation:

Salary Range: $32.50 - $52.00





Union Position:

No



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.

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.

Job Description

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.

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 1-877-949-5678 or send an email to talent@sanfordhealth.org.

The Sanford organization owns and manages multiple distinct brands, including Sanford Health, Marshfield Clinic, and Good Samaritan, as well as Lewis Drug, Sanford Health Equip, Solutions by Sanford, Great Shots, and Blue Rock Bar & Grill.

About Sanford Health

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. Headquartered in Sioux Falls, South Dakota, the organization has 53,000 employees and serves over 2 million patients and nearly 425,000 health plan members across the upper Midwest including South Dakota, North Dakota, Minnesota, Wyoming, Iowa, Wisconsin and the Upper Peninsula of Michigan. The integrated nonprofit health system includes a network of 56 hospitals, 288 clinic locations, 147 senior care communities, 4,000 physicians and advanced practice providers and nearly 1,500 active clinical trials and studies. The organization’s transformational virtual care initiative brings patients closer to care with access to 78 specialties. Learn more about Sanford Health’s commitment to shaping the future of rural health care across the lifespan at sanfordhealth.org or Sanford Health News.

About Good Samaritan

Good Samaritan, one of the nation’s largest nonprofit providers of senior care and services, is committed to transforming the aging experience through innovation, compassion and personalized care. As part of Sanford Health, an integrated nonprofit health system headquartered in Sioux Falls, South Dakota, Good Samaritan serves 10,000 seniors and offers access to a full continuum of care, including 94 rehabilitation and skilled nursing centers, 56 assisted living and memory care facilities, 44 independent living locations and 37 home health and hospice agencies. The senior care provider delivers services across the upper Midwest, with 70% of residents living in rural communities. Learn more about Good Samaritan’s mission and commitment to delivering high quality senior care in rural America at good-sam.com.