job

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.

What you will bring:

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 analytical, organizational, and problem-solving skills.

Licenses/Certifications: A valid driver’s license and proof of current auto insurance will be required for any position requiring driving.

Together we will be: an innovative and collaborative team who supports each other, the employees and vision of the company to reach our goals individually, together and as an organization.

Pay, Perks and Benefits at Colorado Access:

The compensation for this position is $118,500 .00- $140,200.00 annually. Colorado Access has provided a compensation range that represents its good faith estimate of what Colorado Access may pay for the position at the time of posting. Colorado Access may ultimately pay more or less than the posted compensation range. The salary offered to the selected candidate will be determined based on factors such as the qualifications of the selected candidate, departmental budget availability, internal salary equity considerations, and available market information, but not based on a candidate’s sex or any other protected status.

In addition to being part of a mission driven organization serving our community, as an eligible Colorado Access employee, you’ll receive a generous benefits package, that includes:

Medical, dental, vision insurance that starts the first day of the month following start date.
Supplemental insurance such as critical illness and accidental injury.
Health care and dependent care flexible spending account options.
Employer-paid basic life insurance and AD&D (employee, spouse and dependent).
Short-term and long-term disability coverage.
Voluntary life insurance (employee, spouse, dependent).
Paid time off
Retirement plan
Tuition reimbursement (based on eligibility).
Annual bonus program (based on eligibility, requirements and performance).

Where you will work:

This position will be a hybrid model work environment, a blend of ‘In-Office’ and ‘Remote.’

We are not able to support out of state employees at this time as we continue to serve our members and community in the metro Denver area and across the beautiful state of Colorado.

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