Business Operations Senior Manager (215670)

Job Title: Business Operations Senior Manager  

Job ID: 215670

Location: Shawnee County

Job Posting Closes: July 20, 2025

Kansas Department of Health and Environment:  

Our agency is led by Secretary Janet Stanek, who was appointed by Gov. Kelly in Dec 2021. KDHE is comprised of three divisions: Public Health, Environment, and Health Care Finance (which includes the State’s Medicaid program, KanCare). We are the only agency in the nation to have these three entities under one roof which allows us to take a holistic approach to improving and protecting the health and well-being of all Kansans.

About the Position

• Who can apply: External (Open to Anyone)
• Classified/Unclassified Service: Unclassified
• Full-Time/Part-Time: Full-time
• Regular/Temporary: Regular
• Work Schedule: Monday-Friday, 8am-5pm (Flexible schedules available)
• Eligible to Receive Benefits: Yes
• Veterans' Preference Eligible: Yes

Compensation: 

• Hourly Pay Range: $31.22 - $36.14

* Salary can vary depending upon education, experience, or qualifications. 

Employment Benefits

• Comprehensive medical, mental, dental, vision, and additional coverage
• Sick & Vacation leave
• Work-Life Balance programs: parental leave, military leave, jury leave, funeral leave
• Paid State Holidays (designated by the Governor annually)
• Fitness Centers in select locations
• Employee discounts with the STAR Program
• Retirement and deferred compensation programs

Visit the Employee Benefits page for more information… 

Position Summary & Responsibilities

The position (K0246466)

The Kansas Department of Health and Environment has an opening for a Business Operations Senior Manager in Topeka. This position is a Hybrid Position and does require working some days every week in the office. Because of this, you need to be located within an hour of Topeka.

Business Operations Oversight: Directs fiscal agent activities regarding business operations initiative, priorities, and issues. Coordinates with other DHCF functions on issues related to claims and encounters. Supports the Provider and Managed Care teams by providing necessary input to claims and encounter questions and assisting all teams with audit activities related to the quality and completeness of claims and encounter data. Evaluates and adjusts operational practices, procedures, and activities for the team daily to ensure overall efficiency and focus on priority items. Participates in the implementation of policy changes affecting claims payment. Works closely with the other areas within the agency and the fiscal agent to ensure claims are processed timely and accurately according to Kansas program policy guidelines. Reviews all reports pertaining to claims and encounters which monitor the performance of the fiscal agent contractor and MCOs and will initiate corrective action as needed. Escalates high priority issues to leadership. Provide interpretation of guidelines regarding claim and encounter data processing. Assist team and MCOS in coordinating activities with subcontractors. Implement processes that are used to monitor requirements for all aspects of claims processing and encounter data submissions. Monitor quality performance standards and contract compliance for claims and encounters.

Provide Subject Matter Expertise to support Business Operations: Review existing team processes for improvement. Acts as a subject matter expert and business lead for new projects or changes impacting claims and encounters. Acts as a subject matter expert for claims and encounter processing, including providing interpretation of policies and guidelines. Understands the components of claims, claims edits, and the claims process. Understands the components of encounters and the encounter process. Review new processes being proposed to ensure business needs will be met efficiently and with a minimum of complexity. Reviews project deliverables for accuracy and completeness. Assists with review and feedback for Requests for Proposal, contracts, or other agreements impacting claims and encounters. This includes providing operational requirements that MCOs, the fiscal agent, and other organizations must follow to meet state and federal requirements for claims and encounters. Support program and system project implementations that impact claims and encounters by supplying information, providing guidance, and reviewing documentation as needed.

Job Responsibilities may include but are not limited to the following:   

Audits: Participate in audit activities for all required state and federal audits, including participating in sessions, gathering and presenting information, responding to questions, and addressing findings. Perform audits on the MCOs to ensure all claim and encounter policies for Kansas Medicaid are documented and correctly followed.

Communication: Responds to and oversees preparation of responses to written/verbal inquiries received related to claims payment issues. Develops positive working relationships with the fiscal agent, MCOs, providers, and other partners. Work with Director of Medicaid Operations and the Director of Managed Care on desired course of action in response to proposed legislation or other items as needed. Supports Federal and State audits to ensure auditors have access to needed data. Coordinates ad hoc data requests for audits, legislative inquiries, sister agencies, and other research requests to ensure the data are collected and distributed on time. Prepares weekly status reporting on team activities.

Supervisory: Directly supervises the Claims supervisor and indirectly supervises the rest of the Business Operations team. Ensures that the performance review process is completed timely for direct and indirect reports. Responsible for mentoring and cross training of staff in the unit. Monitor tasks to ensure issues and questions are being directed to the appropriate team. Assist the claims supervisor with the prioritization and distribution of work. Meet with team weekly to ensure they have current instructions and directions to do their job effectively. Will back up the claim’s supervisor in managerial/supervisor tasks, such as making team assignments, monitoring work ques, prioritizing team tasks, reviewing/approving timecards, and mid-year/annual performance reviews.

Financial Processes: Work with the Financial Processes Manager to ensure processes related to accounts receivables, accounts payables, debt setoff, and legal referrals are handled timely and accurately. Coordinates State and contractor activities related to financial processes. Coordinates reporting efforts with the fiscal team to ensure the State of Kansas is receiving all funds due.

Qualifications

Education:  

• High School, GED

Licensing & Certification:

• Valid Driver's License - Incumbent is required to have and maintain a valid driver's license when operating a state vehicle, a private vehicle, or a rental vehicle for the benefit of the State

Minimum Qualifications:

• Two years of experience in a health care environment directing or supervising government programs such as Medicare, commercial insurance industry, or medical claims administration.  One year of experience in collecting, evaluating, studying or reporting on healthcare, statistical, economic, legislative or administrative data.
• Bachelor’s degree in health care administration, Finance or another related field
• Word, Excel, PowerPoint, Access
• Written and verbal communication skills
• Staff management and supervisory experience

Preferred Qualifications:  

• Proofreading, editing, attention to detail
• Analytical / troubleshooting skills
• Familiarity with claims data and edits
• Knowledge of healthcare claims and billing
• Medical terminology and CPT/HCPCS/ICD10 code knowledge would be helpful
• Familiarity with encounter data and 834 process and working with Managed Care Organizations
• Process improvement
• Experience with leading business initiatives and managing staff
• Experience with financial processes and reporting related to claims/encounters

Recruiter Contact Information

• Name: Tracey Benson
• Email: Tracey.N.Benson@ks.gov
• Mailing Address: 1000 SW Jackson St. Suite 580 Topeka, KS 66612
• Please include the Job ID number when emailing.

Job Application Process:  Only applications submitted within our State of Kansas Careers Portal will be considered. 

• First Sign in or register as a New User at https://admin.ks.gov/offices/personnel-services/jobs 
• Complete or update your contact information on the State of Kansas Careers Portal > My Contact Information page. *This information is included on all your job applications.
• Upload required documents listed for each specific job posting. 
• Start your draft job application, upload other required documents, and submit when it is complete.
  • Manage your draft and submitted applications on the Careers> My Job Applications page.
• Check your email and My Job Notifications for written communications from the Recruiter.
  • Email – sent to the Preferred email on the My Contact Information page.
  • Notifications – view the Careers> My Job Notifications page.

Helpful Resources at jobs.ks.gov: “How to Apply for a Job – Instructions” and “How to Search for a Job – Instructions."