POSITION SUMMARY/RESPONSIBILITIES
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.
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