Network Adequacy Manager

About the role

The State of Georgia’s Insurance Department is seeking a Network Adequacy Manager to oversee compliance with federal and state network adequacy standards for Qualified Health Plans and off‑Exchange ACA plans. Reporting to senior leadership, the manager will guide analytical teams, coordinate with vendors, and ensure timely certification cycles.

Key responsibilities

• Monitor issuer compliance with O.C.G.A. § 33‑20E‑1 et seq. and CMS 45 CFR 156.230 requirements.
• Lead a team of analysts and external vendors in reviewing network adequacy submissions and producing quarterly dashboards.
• Interpret CMS notices, NAIC guidance, and regulatory publications to assess statewide impacts.
• Validate issuer justifications for network gaps and determine market constraints versus recruitment issues.
• Prepare and deliver regular briefings to leadership on compliance risks and network sufficiency trends.
• Establish certification timelines and coordinate with the Georgia Access program and other agency divisions.

Required profile

• Undergraduate degree in health policy, public administration, or a related field.
• Experience in health‑insurance regulation, network adequacy analysis, or similar compliance roles.
• Strong analytical and report‑writing abilities.
• Ability to manage staff, vendors, and cross‑agency collaborations.

Required skills

What we offer

• Competitive salary range of $75,000‑$100,000.
• Comprehensive benefits package for Georgia state employees.
• Opportunity to influence health‑care access for over 10 million residents.