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Operations Manager- Health Insurance

2 months ago

atlanta, United States Focus People Full time

Operations Manager - Health Insurance (Plan Manager / Policy / Compliance)


Location: Atlanta, GA 30334

Type: Direct Hire

Salary: $120K - $140K/year


Job Description

Are you a seasoned healthcare operations professional with a deep understanding of health insurance plans and compliance? We're seeking an experienced Operations Manager to oversee the review, certification, and compliance of Quality Health Plans (QHPs) and Stand-Alone Dental Plans (SADPs) for Georgia Access and the Small Business Health Options Program (SHOP).


Responsibilities:


  • Manage day-to-day health insurance carrier operations, serving as the primary point of contact for Georgia Access.
  • Oversee plan certification, ensuring compliance with federal and state regulations.
  • Build and maintain strong relationships with health insurance carriers.
  • Lead a team of analysts in supporting carrier operations and issue resolution.
  • Prepare for and support annual Open Enrollment activities.
  • Analyze market trends and implement strategies to improve plan offerings.
  • Ensure compliance with ACA regulations and state-specific requirements.
  • Manage the SHOP program, including employer enrollment and eligibility.


Qualifications:


  • Bachelor's degree in operations management, business administration, or related field.
  • 7+ years of managerial or supervisory experience in healthcare operations.
  • In-depth knowledge of health insurance plans, regulations, and compliance.
  • Strong analytical, problem-solving, and communication skills.
  • Experience managing vendor relationships and complex projects.
  • Ability to thrive in a fast-paced, dynamic environment.


Preferred Qualifications:


  • Experience with Serff system and health technology systems.
  • Knowledge of Georgia's healthcare market and provider networks.


This is a hybrid position with the flexibility to work remotely 2 days per week. Some Saturday availability may be required during peak Open Enrollment season (November - January).


If you are a results-oriented leader with a passion for healthcare and a strong understanding of the insurance industry, we encourage you to apply.