ACA Program Integrity Lead — Hybrid

Blue Cross Blue Shield of Arizona; Phoenix (AZ); Hybrid; USD 90,000 - 130,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

Blue Cross Blue Shield of Arizona seeks an ACA Program Integrity Coordinator to serve as a subject matter expert for ACA program integrity, compliance deliverables, vendor performance, and service delivery oversight.

This role manages day-to-day vendor relationships, monitors regulatory and contractual performance, supports QHP and Open Enrollment readiness, validates vendor activity, and partners with internal teams to drive process improvements and risk mitigation.

Qualifications

• Five years of experience in health insurance back-office operations, quality and compliance programs, product development, vendor management, financial operations, business operations, or a related field.
• Three years of experience leading process improvement or designing and implementing business processes according to customer or operational specifications.
• Experience working with vendor invoices, budgets, purchase orders, financial tracking, vendor performance, contracts, or service agreements.
• Bachelor's degree in Business, Finance, Healthcare Operations, Healthcare Administration, or a related field.

Responsibilities

• Maintain current knowledge of ACA, Centers for Medicare & Medicaid Services, Federally Facilitated Exchange, and Qualified Health Plan regulatory requirements.
• Review regulatory guidance, operating manuals, training materials, and program updates, and translate requirements into clear actions for internal owners and business partners.
• Identify gaps in policies, procedures, controls, and documentation.
• Draft or update materials that support regulatory compliance and operational consistency.
• Coordinate audit responses, corrective action plans, and supporting documentation for internal, regulatory, and vendor-related audit obligations.
• Conduct research, analysis, data gathering, and issue investigation to support regulatory deliverables and leadership decisions.

Skills

Health insurance ops

Quality & compliance

Vendor management

Financial operations

Business operations

Education

Bachelor's degree

Job description

Blue Cross Blue Shield of Arizona seeks an ACA Program Integrity Coordinator to serve as a subject matter expert for ACA program integrity, compliance deliverables, vendor performance, and service delivery oversight.

This role manages day-to-day vendor relationships, monitors regulatory and contractual performance, supports QHP and Open Enrollment readiness, validates vendor activity, and partners with internal teams to drive process improvements and risk mitigation.