{"schemaVersion":"jobsearcher.job.v1","id":"f7fc8a1f293cc26e385eb520","url":"https://jobsearcher.com/jobs/f7fc8a1f293cc26e385eb520","canonicalUrl":"https://jobsearcher.com/jobs/f7fc8a1f293cc26e385eb520","title":"Manager, Provider Network & Basic Health Plan Implementation","description":"Company Overview\nEnlightened 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.\nPosition Responsibilities\nImplementation Leadership\nLead end-to-end implementation of the Basic Health Plan across the provider network.\nDevelop and manage project plans, timelines, and deliverables with internal and external stakeholders.\nProvider Network Coordination\nOversee provider onboarding, contracting, and integration processes specific to the BHP.\nServe as the primary liaison between provider organizations and internal departments to ensure alignment and compliance.\nPerformance & Compliance Oversight\nMonitor provider performance metrics to ensure adherence to health plan standards and regulatory requirements.\nCollaborate with compliance and quality teams to address performance gaps and implement corrective actions.\nProcess Improvement & Strategy\nIdentify opportunities to streamline workflows and enhance provider engagement.\nContribute to strategic planning initiatives for network expansion and program optimization.\nStakeholder Engagement\nFacilitate communication with state agencies, health plan partners, and provider organizations.\nPrepare reports, presentations, and updates for executive leadership and regulatory bodies.\nTeam Leadership\nProvide mentorship, performance management, and professional development to direct reports.\nFoster a collaborative, accountable, and results-driven team culture.\nData Analysis & Reporting\nUse advanced Excel skills to analyze provider data, track implementation progress, and generate actionable insights.\nCreate dashboards, models, and reports to support strategic decisions.\nRequired Qualifications\nBachelor’s degree in healthcare administration, public health, business, or a related field (Master’s preferred).\n5+ years of experience in provider network management, health plan operations, or healthcare project implementation.\nDemonstrated leadership experience with a track record of managing teams and achieving results.\nStrong knowledge of Medicaid, Basic Health Plans, and provider contracting.\nExpert-level proficiency in Microsoft Excel (pivot tables, formulas, and data visualization).\nExcellent communication, negotiation, and stakeholder engagement skills.\nPreferred Skills\nExperience working with state health agencies or managed care organizations.\nFamiliarity with value-based care models and provider performance analytics.\nProficiency with project management tools and healthcare data systems.\nBenefits:\nThe 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.\nAt Enlightened, we pride ourselves on offering a comprehensive and industry-competitive benefits package to our full-time employees. Our benefits include:\nMedical/Dental/Vision Insurance with Health Savings Accounts (HSA)\nFlexible Spending Accounts (FSA)\n401(k) Retirement Plan\nPaid Holidays, Vacation, & Sick Leave\nProfessional Training & Development Reimbursement\nPlease note, these benefits are available exclusively to full-time employees of Enlightened.\nEqual Opportunity Statement\nEnlightened is proud to 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, disability, or any other federal, state, or local protected class.","company":"Enlightened","rawCompany":"enlightened","city":"Washington","state":"DC","isRemote":false,"isActive":false,"createdAt":"2026-04-09T11:43:48.010Z","occupations":[{"code":"11-9111.00","title":"Medical and Health Services Managers","slug":"medical-and-health-services-managers"},{"code":"13-1082.00","title":"Project Management Specialists","slug":"project-management-specialists"},{"code":"11-1021.00","title":"General and Operations Managers","slug":"general-and-operations-managers"}],"industries":[{"code":"524114","title":"Direct Health and Medical Insurance Carriers","slug":"direct-health-and-medical-insurance-carriers"},{"code":"923120","title":"Administration of Public Health Programs","slug":"administration-of-public-health-programs"},{"code":"622110","title":"General Medical and Surgical Hospitals","slug":"general-medical-and-surgical-hospitals"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Manager, Provider Network & Basic Health Plan Implementation","description":"Company Overview\nEnlightened 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.\nPosition Responsibilities\nImplementation Leadership\nLead end-to-end implementation of the Basic Health Plan across the provider network.\nDevelop and manage project plans, timelines, and deliverables with internal and external stakeholders.\nProvider Network Coordination\nOversee provider onboarding, contracting, and integration processes specific to the BHP.\nServe as the primary liaison between provider organizations and internal departments to ensure alignment and compliance.\nPerformance & Compliance Oversight\nMonitor provider performance metrics to ensure adherence to health plan standards and regulatory requirements.\nCollaborate with compliance and quality teams to address performance gaps and implement corrective actions.\nProcess Improvement & Strategy\nIdentify opportunities to streamline workflows and enhance provider engagement.\nContribute to strategic planning initiatives for network expansion and program optimization.\nStakeholder Engagement\nFacilitate communication with state agencies, health plan partners, and provider organizations.\nPrepare reports, presentations, and updates for executive leadership and regulatory bodies.\nTeam Leadership\nProvide mentorship, performance management, and professional development to direct reports.\nFoster a collaborative, accountable, and results-driven team culture.\nData Analysis & Reporting\nUse advanced Excel skills to analyze provider data, track implementation progress, and generate actionable insights.\nCreate dashboards, models, and reports to support strategic decisions.\nRequired Qualifications\nBachelor’s degree in healthcare administration, public health, business, or a related field (Master’s preferred).\n5+ years of experience in provider network management, health plan operations, or healthcare project implementation.\nDemonstrated leadership experience with a track record of managing teams and achieving results.\nStrong knowledge of Medicaid, Basic Health Plans, and provider contracting.\nExpert-level proficiency in Microsoft Excel (pivot tables, formulas, and data visualization).\nExcellent communication, negotiation, and stakeholder engagement skills.\nPreferred Skills\nExperience working with state health agencies or managed care organizations.\nFamiliarity with value-based care models and provider performance analytics.\nProficiency with project management tools and healthcare data systems.\nBenefits:\nThe 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.\nAt Enlightened, we pride ourselves on offering a comprehensive and industry-competitive benefits package to our full-time employees. Our benefits include:\nMedical/Dental/Vision Insurance with Health Savings Accounts (HSA)\nFlexible Spending Accounts (FSA)\n401(k) Retirement Plan\nPaid Holidays, Vacation, & Sick Leave\nProfessional Training & Development Reimbursement\nPlease note, these benefits are available exclusively to full-time employees of Enlightened.\nEqual Opportunity Statement\nEnlightened is proud to 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, disability, or any other federal, state, or local protected class.","datePosted":"2026-04-09T11:43:48.010Z","dateModified":"2026-04-09T11:43:48.010Z","hiringOrganization":{"@type":"Organization","name":"Enlightened","sameAs":"https://jobsearcher.com"},"jobLocation":{"@type":"Place","address":{"@type":"PostalAddress","addressLocality":"Washington","addressRegion":"DC","addressCountry":"US"}},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"f7fc8a1f293cc26e385eb520"},"url":"https://jobsearcher.com/jobs/f7fc8a1f293cc26e385eb520"}}