Hybrid Manager, Provider Network & Basic Health Plan Implementation at Enlightened

Company Overview

 Enlightened is seeking an experienced Manager, Provider Network & Basic Health Plan Implementation to lead the strategic execution and operational rollout of the Basic Health Plan (BHP) within the provider network. This position ensures seamless provider integration, manages cross-functional coordination, and drives performance outcomes aligned with both regulatory requirements and organizational goals. The Manager may oversee a team of direct reports and will leverage advanced Excel expertise to support data-driven decision-making. 

Position Responsibilities

Implementation Leadership

• Lead end-to-end implementation of the Basic Health Plan across the provider network.
• Develop and manage project plans, timelines, and deliverables with internal and external stakeholders. 

Provider Network Coordination

• Oversee provider onboarding, contracting, and integration processes specific to the BHP.
• Serve as the primary liaison between provider organizations and internal departments to ensure alignment and compliance. 

Performance & Compliance Oversight

• Monitor provider performance metrics to ensure adherence to health plan standards and regulatory requirements.
• Collaborate with compliance and quality teams to address performance gaps and implement corrective actions. 

Process Improvement & Strategy

• Identify opportunities to streamline workflows and enhance provider engagement.
• Contribute to strategic planning initiatives for network expansion and program optimization. 

Stakeholder Engagement

• Facilitate communication with state agencies, health plan partners, and provider organizations.
• Prepare reports, presentations, and updates for executive leadership and regulatory bodies. 

Team Leadership

• Provide mentorship, performance management, and professional development to direct reports.
• Foster a collaborative, accountable, and results-driven team culture. 

Data Analysis & Reporting

• Use advanced Excel skills to analyze provider data, track implementation progress, and generate actionable insights.
• Create dashboards, models, and reports to support strategic decisions. 

Required Qualifications

• Bachelor’s degree in healthcare administration, public health, business, or a related field (Master’s preferred).
• 5+ years of experience in provider network management, health plan operations, or healthcare project implementation.
• Demonstrated leadership experience with a track record of managing teams and achieving results.
• Strong knowledge of Medicaid, Basic Health Plans, and provider contracting.
• Expert-level proficiency in Microsoft Excel (pivot tables, formulas, and data visualization).
• Excellent communication, negotiation, and stakeholder engagement skills. 

Preferred Skills

• Experience working with state health agencies or managed care organizations.
• Familiarity with value-based care models and provider performance analytics.
• Proficiency with project management tools and healthcare data systems.

Benefits:

The expected salary range for this position is listed above.  Actual compensation will be determined based on experience and qualifications as well as internal equity and alignment with market data. 

At Enlightened, we pride ourselves on offering a comprehensive and industry-competitive benefits package to our full-time employees. Our benefits include:  

• Medical/Dental/Vision Insurance with Health Savings Accounts (HSA)
• Flexible Spending Accounts (FSA)
• 401(k) Retirement Plan
• Paid Holidays, Vacation, & Sick Leave
• Professional Training & Development Reimbursement  

Please note, these benefits are available exclusively to full-time employees of Enlightened.  

Enlightened is proud be an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.