Director of Exchange Operations

The vision of Colorado Access is to have healthy communities transformed by the care that people want at a cost we can all afford. Our mission is to partner with communities and empower people through access to quality, affordable care.

Why should you consider a career with Colorado Access?

We are a Colorado-based company, working to improve the health of our state. We care for individuals, families, and children who receive health care under Child Health Plan Plus (CHP+) and Health First Colorado (Colorado's Medicaid Program). Our focus is driving improvements in quality, member experience, outcomes, and cost. We are a mission-driven organization whose foundation is built by our vision, supported by our values and pillared by diversity, equity and inclusion.

• Find work/life balance:
  We offer PTO, floating holidays, nine company paid holidays, a hybrid work environment, an Employee Assistance Program and a 401K.
• Be a part of something bigger and make an impact:
  We serve the underserved and most vulnerable populations in our community through access to quality and affordable health care. No matter what you do for Colorado Access, you are impacting our community and making a difference.
• Sharpen your skills, learn, and grow:
  We support your continued development through tuition reimbursement, leadership training, promotion opportunities, performance evaluations, employee recognition, and a language pay stipend.

What you will do:

We are looking for a DIRECTOR OF EXCHANGE OPERATIONS who can help shape our vision and support our mission. Here is what the position will look like.

• Provides strategic direction and oversees the management and maintenance of department deliverables striving for operational excellence (productivity, quality, SLAs, customer experience of services provided, etc.). Builds high performing teams with vision, leadership, goals and metrics. Serves as a role model for team members; takes action and inspires team members to embrace and implement culture initiatives. Provides awareness to staff how their work impacts other departments, programs and the enterprise.
  
  Encourages collaboration and holds team members accountable for achieving outstanding results.
• Responsible for all management functions including: hiring, training, planning and directing work, coaching and staff development, managing and evaluating performance, recognizing and rewarding employees; corrective action procedures and practices, addressing complaints and resolving problems. Develops and manages the department budget.

• Works closely with Directors across the organization to make tactical and operational decisions that advance company strategies and goals and collaborates to deliver on company-wide deliverables/requirements.

• Oversees/leads departmental projects and continuous improvement initiatives; may lead cross functional teams.
• Develops and implements department policies and procedures to ensure compliance with federal, state, local and company policies, rules and regulations.

• The Director of Exchange Operations works collaboratively with company operations, functional areas, other lines of business, and external vendors to identify opportunities for process improvement to drive compliance and efficiency.
• Facilitates transparent communication around objectives and performance between Exchange Segment, Enterprise functions and local health plan Operations.
• Proactively develops, tracks, and reports performance relative to Marketplace compliance requirements, key performance targets and/or associated service level agreements to Exchange Segment leadership.
• Quickly escalates performance issues to the Exchange Segment leader and works collaboratively to develop action plans to mitigate.
• Works collaboratively with corporate business owners, local health plans and the Exchange Segment to identify best practices and opportunities for process improvement to drive compliance and efficiency.
• Develops 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, G&A timeliness, etc.).
• Directs 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.
• Closely partners with Compliance and Internal Audit to identify risk areas and ensure appropriate oversight and closure of internal and external corrective action plans.
• Ensure adherence to federal, state, and local ACA regulations including CMS, HIPAA, and other relevant standards.
• Partner with compliance officers to maintain audit readiness and contractual obligations.
• Implement quality assurance protocols and performance metrics.
• Partners with project management/implementation leader to create and execute on plans for risk mitigation and process improvement.
• Provides oversight for provider…