Manager of Marketplace Business Operations

Thevision of Colorado Accessis to have healthy communities transformed by the care that people want at a cost we can all afford. Our mission is to partner with communities and empower people through access to quality, affordable care.

We are a Colorado-based company, working to improve the health of our state. We care for individuals, families, and children who receive health care under Child Health Plan Plus (CHP+) and Health First Colorado (Colorado's Medicaid Program). Our focus is driving improvements in quality, member experience, outcomes, and cost. We are a mission-driven organization whose foundation is built by our vision, supported by our values and pillared by diversity, equity and inclusion.

• Find work/life balance:
  We offer PTO, floating holidays, nine company paid holidays, a hybrid work environment, an Employee Assistance Program and a 401K.
• Be a part of something bigger and make an impact :
  We serve the underserved and most vulnerable populations in our community through access to quality and affordable health care. No matter what you do for Colorado Access, you are impacting our community and making a difference.
• Sharpen your skills, learn, and grow :
  We support your continued development through tuition reimbursement, leadership training, promotion opportunities, performance evaluations, employee recognition, and a language pay stipend.

We are looking for a MANAGER OF MARKETPLACE BUSINESS OPERATIONS who can help shape our vision and support our mission. Here is what the position will look like.

• Manage day-to-day business operations to ensure timely, compliant, and efficient business processes. Ensure compliance with healthcare regulations, marketplace contracts, and organizational policies.
• Lead operational readiness efforts to prepare the organization for Open Enrollment Period (OEP), ensuring all departments are aligned and equipped for successful execution.
• Facilitate cross-functional coordination between departments to ensure operational excellence and continuity across business functions.
• Oversee vendor relationships for the Marketplace segment, ensuring performance, contract compliance, and service quality.
• Maintain an accurate and comprehensive understanding of exchange operations, including regulatory requirements, process flows, and system dependencies.
• Works collaboratively with corporate business owners, and the Marketplace segment to identify best practices and opportunities for process improvement to drive compliance and efficiency.
• Develop and maintain standard operating procedures (SOPs) that align with business objectives and regulatory standards.

• Develop strategies and tactics in partnership with Health Plan Service Operations to mitigate any performance issues to ensure established service levels are met (i.e. claims accuracy, A&G timeliness, etc.)
• Monitor key performance indicators (KPIs) and operational metrics to identify trends and drive data-informed decision-making.
• Leads analytical activities to identify trends and potential opportunities for root cause analysis with those Corporate Operations functions that may impact the functionality of Marketplace Operations
• Partners with project management/implementation leader to create and execute plans for risk mitigation and process improvement
• Provides oversight for provider relations operations to support the Account Executive function in each participating region.

• Collaborate with Compliance and Legal teams to maintain audit readiness and adherence to federal, state, and payer requirements.
• Supervise, coach, and develop a team of operations specialists and analysts, as applicable.

Education
:
Bachelor’s degree in healthcare administration, public policy, business, or related field; or an equivalent combination of education and experience can be substituted. Master’s degree preferred.

Experience
:
Minimum of five years of progressive experience in ACA Individual, Medicaid/Medicare managed care, or health insurance operations. Two years of supervisory or management experience required. Strong understanding of healthcare systems, payer/provider relationships, and exchange operational workflows.

Knowledge, Skills, and Abilities
:
Demonstrates support for the company’s mission, vision, and values. Position requires excellent written and verbal communication skills. Must be proficient in Microsoft Office applications (Word, Excel, PowerPoint, Outlook, SharePoint) with the ability to work with a variety of project management tools. May be required to manage multiple priorities and projects with tight deadlines. Deep understanding of ACA Exchange dynamics and government program operations.

Experience in high-growth environments and managing remote or hybrid teams. Ability to translate strategic goals into measurable operational initiatives. Proven ability to manage multiple priorities and deliver results in a fast-paced, evolving environment. Excellent…