ACA Program Integrity Lead — Hybrid AZ Role

Blue Cross Blue Shield of Arizona; Phoenix (AZ); Hybrid; USD 90,000 - 125,000; Full time

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, regulatory deliverables, vendor performance, and service delivery oversight.

You will manage day-to-day vendor relationships, monitor regulatory and contractual performance, support QHP and Open Enrollment readiness, validate vendor financial activity, and partner with internal teams to drive risk reduction and process improvements.

Qualifications

• Five years of experience in health insurance back-office operations, quality and compliance programs, product development, vendor management, financial operations, or related fields.
• Three years of experience leading process improvement or designing and implementing business processes to customer/operational specs.
• Experience supporting compliance, privacy, government programs, healthcare operations, legal matters, or regulatory deliverables.

Responsibilities

• Maintain current knowledge of ACA, CMS, FFEs, and QHP regulatory requirements.
• Assess gaps in policies, procedures, controls, and documentation; translate requirements into actionable steps.
• Coordinate audit responses and action plans for regulatory/vendor audits; gather supporting documentation.
• Lead day-to-day vendor relationship management and track performance against SLAs and regulatory commitments.
• Develop dashboards, scorecards, and reports; work with cross-functional teams to resolve issues and drive remediation.

Skills

Vendor management

Regulatory compliance

Process improvement

Data analysis

Stakeholder communication

Education

Bachelor’s degree in Business/Finance/Healthcare Ops

Tools

Vendor management platforms

Microsoft Excel

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, regulatory deliverables, vendor performance, and service delivery oversight.

You will manage day-to-day vendor relationships, monitor regulatory and contractual performance, support QHP and Open Enrollment readiness, validate vendor financial activity, and partner with internal teams to drive risk reduction and process improvements.