Director, ACA Individual (Hybrid)

$143,280 - $265,964/Yr

CareFirst of Maryland - Baltimore, MD

Full-time - Senior

Baltimore, MD

Ambulatory Health Care Services

About the position

The Director, ACA Individual is responsible for leading the operation of ACA Individual programs across multiple jurisdictions. This role involves strategic direction for business development, ensuring profitability, growth, and stability. The Director will oversee business direction, financial performance, growth strategy, product direction, and the multi-year strategy necessary to achieve the overall government programs strategic plan. Collaboration with various leaders in marketing, finance, government relationships, operations, health services, and compliance is essential to drive membership growth and ensure quality and compliance.

Responsibilities

• Develop and oversee implementation of annual business plan and components of the 3-year strategic plan.
• Establish business objectives for all matrixed and direct functions supporting the business area.
• Work with matrixed business leaders to develop strategies to execute defined business objectives.
• Establish business objectives for membership growth that align with the business plan and strategic objectives.
• Integrate strategies to increase membership through alternative sources and community relationships.
• Assess changes in the external environment and develop plans to address implications.
• Translate strategic plans into tactical goals and lead measures to ensure performance measures are met.
• Design and develop appropriate products leveraging a government program focused product team.
• Drive the strategic government programs marketing and communications plan.
• Collaborate with cross-functional leaders to identify and implement opportunities for improving operational performance.
• Ensure compliance with all business, administrative, and relevant regulations in collaboration with the ACA Compliance Officer.
• Lead financial performance to meet membership, earnings, and quality targets.
• Provide profit and loss (P&L) leadership and operational oversight.
• Accountable for successful deployment of the financial plan to deliver required growth in membership.

Requirements

• Bachelor's Degree in a relevant field.
• 8 years' experience in ACA Individual, Medicare or Medicaid managed care, managed care insurance, finance, government, or healthcare setting.
• 5 years of progressively responsible management experience.

Nice-to-haves

• Advanced degree in business or related field.
• Experience in market strategy, sales, marketing, network management, or medical cost management.

Benefits

• Comprehensive benefits package
• Various incentive programs/plans
• 401k contribution programs/plans