Government Programs Analyst

University Health; San Antonio (TX); In loco; USD 90.000 - 110.000; Tempo pieno

Descrizione del lavoro

Community First Health Plans, Inc. in Texas seeks a leader to oversee Marketplace and Medicare Advantage programs. You will coordinate with clinical and administrative teams to ensure day-to-day operational effectiveness and act as the primary liaison with CMS and the Texas Department of Insurance.

The role requires a health administration or related degree, with experience in Marketplace or Medicare and strong knowledge of ACA and Medicare regulations.

Competenze

• Bachelor’s degree required in health administration, business administration or related field.
• Two years of recent Marketplace or Medicare experience preferred.
• Knowledge of ACA and Medicare regulations, regulatory filings, billing and enrollment required.

Mansioni

• Owns oversight of Community First Health Plans Marketplace and Medicare Advantage plans.
• Provides administrative and operational direction across clinical and administrative teams.
• Serves as liaison with CMS and TDI for Marketplace and Medicare Advantage products.
• Assists with development, implementation and management of regulatory deliverables.

Conoscenze

Regulatory knowledge

Healthcare administration

CMS liaison

Formazione

Bachelor's degree in health administration, business administration or related field

Descrizione del lavoro

Responsible for the oversight of the Community First Health Plans, Inc. (Community First) Marketplace and Medicare Advantage plans. Provides administrative and operational direction by collaborating with all designated clinical and administrative teams throughout the health plan, ensuring day-to-day operational effectiveness. Serves as a liaison with the Center for Medicare Services (CMS) and Texas Department of Insurance (TDI) for Marketplace and Medicare Advantage products. Assists with the development, implementation and management of all associated regulatory requirements and deliverables.

EDUCATION/EXPERIENCE

A Bachelor’s degree in health administration, business administration or another related field is required. Two years of recent experience in Marketplace or Medicare is preferred. Knowledge of Health Insurance Marketplace (ACA) and Medicare regulations, regulatory filings, billing, enrollment, program policies, services and other regulatory requirements is required.