Business Consultant ACA Individual; Hybrid

Resp & Qualifications

Purpose:

The Business Consultant ACA Individual provides strategic, analytical, and operational expertise to support the design, launch, and execution of initiatives that strengthen ACA Individual market performance. This role contributes directly to Care First's ACA growth strategy by delivering insights, driving operational efficiencies, and supporting cross‑functional alignment in a rapidly evolving healthcare environment.

• Support the development of ACA dashboards in partnership with the external analytics vendor to segment member populations, identify cost‑saving opportunities, and drive performance improvement.
• Leverage analytics to inform ACA marketing strategies by identifying priority populations and geographic segments.
• Collaborate with risk adjustment, care management, quality, and network teams to improve coding performance and overall ACA member outcomes.
• Conduct competitive intelligence analysis to monitor competitor strategies and market actions, informing Care First's market positioning as well as sales and marketing strategies. Serve as the primary internal resource for ACA Individual competitive insights.
• Use data‑driven insights to identify and operationalize opportunities for revenue improvement, cost reduction, and efficiency gains across matrixed business partners.
• Support ICHRA administration, reporting and performance monitoring, including future process enhancements that strengthen data visibility and operational performance.
• Build strong internal partnerships across Care First to deepen functional knowledge, align with core operations, and ensure seamless collaboration with central and divisional teams. Communicate program strategies, updates, and deliverables to leadership and key stakeholders.

Education Level
:
Bachelor's Degree OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Experience: 5 years' experience in business development, operational technology support, general business operations and/or consulting experience.

• Background in healthcare, particularly ACA, Medicare, or Medicaid.
• Prior consulting or managed care experience.
• MBA or other relevant graduate degree.

• Strong understanding of business priorities and organizational goals.
• Awareness of evolving market, industry, and consumer trends.
• Ability to convey complex concepts clearly in both written and verbal formats.
• Exceptional project management, facilitation, and organizational skills.
• Strong relationship‑building and stakeholder management capabilities.
• Strategic thinker and effective problem‑solver with the ability to lead discussions and influence cross-functional engagement.
• High proficiency in Microsoft Office (Excel, PowerPoint, Word).
• Strong analytical capabilities, including experience with tools such as Power BI and advanced Excel.

Salary Range: $88,776 - $176,319

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location.

In addition to your compensation, Care First offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

ACA Individual

Care First Blue Cross Blue Shield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Please visit our website to apply:

Note:

The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Must be eligible to work in the U.S. without Sponsorship