Special Needs Plans (SNP) Operations Manager

About the role

This organization operates within the healthcare sector, focusing on addressing the complex needs of older Americans through specialized Medicare Advantage plans. It aims to improve health and well-being by integrating advanced data technologies with clinical and service experiences to enhance member care. Established in 2017, the organization is positioned to support its mission by fostering innovation and delivering compliant, high-quality healthcare services on a growing scale.

The SPECIAL NEEDS PLANS (SNP) OPERATIONS MANAGER is responsible for overseeing the operational compliance and effectiveness of SNP programs. This role ensures that regulatory requirements are met and operational processes are optimized to support frontline teams in delivering care that aligns with CMS and Medicaid standards. The position plays a crucial role in translating regulatory changes into seamless workflows, thereby maintaining audit readiness and improving member care quality.

Responsibilities

• Develop annual Models of Care in collaboration with leadership.
• Manage policies, procedures, and compliance frameworks to ensure adherence to CMS and Model of Care standards.
• Interpret evolving regulatory requirements and implement operational solutions across teams.
• Enhance compliance monitoring processes, including early detection systems for potential gaps.
• Build expertise in Medicaid benefits and develop support tools for staff and members.
• Coordinate timely and accurate Medicaid reporting with relevant teams.
• Provide additional compliance and operational support across SNP and Medicaid programs as needed.

Requirements

• Minimum 3 years’ experience in Medicare Advantage, Managed Care, Health Plan, or healthcare operations.
• Proven ability to interpret CMS and State Medicaid regulations and implement compliance workflows.
• Detail-oriented, reliable, independent, and curious with experience managing compliance in fast-paced settings.
• Strong communication skills and ability to collaborate with cross-functional teams.

Pay

Salary range: $73,000 - $130,000 per year.

Benefits

• Employer-sponsored health, dental, and vision insurance with low or no premium.
• Generous paid time off.
• $100 monthly mobile or internet stipend.
• Stock options for all employees.
• Bonus eligibility for all roles except Director and above; commission eligibility for sales roles.
• Parental leave program.
• 401K program.