Senior Business Consultant - ACA Individual; Hybrid

Responsibilities

The Sr. Business Consultant ACA Individual serves as a strategic subject-matter expert responsible for designing, launching, and executing initiatives that advance organizational goals within the evolving healthcare landscape. This role is integral to driving ACA market growth by:

• Defining and implementing the ACA Operating Model and Playbook
• Partnering across matrixed teams to lead initiatives with the goal of increasing Care First market share, improving member/broker experience, and strengthening ACA Individual performance.
• Developing ACA dashboards to strengthen enterprise alignment with key performance indicators (KPIs)

• Lead the development of the ACA Individual Operating Model and Playbook, ensuring clear end-to-end ownership of all ACA processes and alignment with defined KPIs, strategic priorities, and performance targets.
• Proactively identify, evaluate, and execute opportunities to improve revenue and reduce costs across ACA product.
• Partner with state and federal exchanges and internal departments to enhance issue resolution timelines and improve exchange satisfaction. Navigate evolving ACA regulations and mitigate against business impact. Work closely with Compliance to refine internal review procedures, strengthen escalation paths, and uphold service-level expectations.
• Identify and implement process improvements that enhance member and broker experiences.
• Support the strategic design and development of new ACA products that meet customer needs and strengthen Care First's competitive position.

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:

10 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, market dynamics, and consumer trends.
• Ability to clearly communicate complex concepts verbally and in writing.
• Effective presentation and facilitation skills.
• Exceptional project management and organizational capabilities.
• Proven ability to build and manage strong professional relationships.
• Strategic thinker with strong problem-solving skills and the ability to drive collaborative outcomes.
• High proficiency in Microsoft Office (Excel, PowerPoint, Word).
• Strong analytical capabilities, including experience with tools such as Power BI and advanced Excel.

$120,000 - $214,500

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