Basic Health Plan Implementation Coordinator

Company Overview

Enlightened is seeking a highly motivated Basic Health Plan (BHP) Implementation Coordinator to support the successful rollout and ongoing operations of the Basic Health Program. This role is essential in coordinating provider network integration, ensuring compliance with state and federal regulations, and fostering cross-functional collaboration to achieve key implementation milestones.

The ideal candidate will be detail-oriented, proactive, and experienced in managing complex projects involving multiple stakeholders, including providers, health plans, and regulatory agencies. A strong background in operations, particularly with a focus on claims resolution, is highly desired.

Position Responsibilities

• Coordinate all aspects of BHP implementation related to provider network management, including onboarding, credentialing, and contract alignment
• Serve as a liaison between internal teams (e.g., compliance, IT, operations) and external stakeholders to ensure timely execution of implementation tasks
• Monitor project timelines, deliverables, and performance metrics to ensure alignment with state BHP requirements
• Support the development and maintenance of provider directories, network adequacy reports, and access standards
• Facilitate training and communication for providers regarding BHP participation, billing protocols, and program updates
• Assist in resolving provider inquiries and issues related to BHP implementation and ongoing participation
• Prepare regular status reports and presentations for leadership and regulatory bodies
• Ensure documentation and workflows are compliant with CMS and state-specific BHP guidelines
  
  

Required Qualifications

• Bachelor’s degree in Public Health, Health Administration, Business, or related field (preferred)
• 3 years of experience in provider network management, health plan operations, or public health program implementation
• Strong understanding of Medicaid, ACA, and Basic Health Program regulations
• Excellent project management and organizational skills
• Strong interpersonal and communication abilities, with experience in stakeholder engagement
• Proficiency in Microsoft Office Suite; experience with provider data systems or project management tools is a plus
  
  

Preferred Skills

• Experience working with state health agencies or managed care organizations
• Familiarity with network adequacy standards and provider credentialing processes
• Ability to translate policy into operational workflows
• Comfort navigating regulatory environments and interpreting compliance requirements
  
  

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 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, and basis of disability or any other federal, state or local protected class.