Medicare & Marketplace Programs Lead

University Health; San Antonio (TX); On-site; USD 90,000 - 110,000; Full time

Job summary

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.

Qualifications

• 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.

Responsibilities

• 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.

Skills

Regulatory knowledge

Healthcare administration

CMS liaison

Education

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

Job description

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.