ACA Program Integrity Coordinator

Blue Cross Blue Shield of Arizona

. Serve as a subject matter expert for Affordable Care Act program integrity, compliance deliverables, vendor performance, and service delivery oversight .

Posted 10/27/2026full-timePhoenix • Arizona • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Affordable Care Act compliance, vendor management, and operational oversight, with a strong focus on regulatory requirements and process improvement. Capable of analyzing vendor performance and financial operations while fostering collaboration across diverse teams.

Highest-signal resume keywords

Affordable Care Act ComplianceVendor ManagementFinancial OperationsProcess ImprovementRegulatory Requirements

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Vendor Performance MonitoringContract ManagementData AnalysisBudget TrackingInvoice ProcessingOperational Risk AssessmentRegulatory Compliance DocumentationBusiness Process DesignQualified Health Plan FilingAudit Coordination

Soft Skills

Analytical SkillsInterpersonal CommunicationVerbal CommunicationWritten CommunicationPrioritization

Tools & Technologies

Spreadsheet SoftwareDatabase SoftwarePresentation SoftwareWord-Processing Software

Industry Keywords

Healthcare OperationsCompliance ProgramsGovernment ProgramsHIPAA Privacy RequirementsQuality Assurance

About the role

Key responsibilities & impact

Serve as a subject matter expert for Affordable Care Act program integrity, compliance deliverables, vendor performance, and service delivery oversight
Manage day-to-day vendor relationships and serve as the primary liaison for assigned ACA vendor relationships
Monitor regulatory and contractual performance, service expectations, and service-level agreements
Support annual Qualified Health Plan filing and Open Enrollment readiness activities
Maintain knowledge of ACA, CMS, FFE, and QHP regulatory requirements
Translate regulatory requirements into clear actions for internal owners and business partners
Identify gaps in policies, procedures, controls, and documentation
Draft and update regulatory compliance and operational consistency materials
Coordinate audit responses, corrective action plans, and supporting documentation
Conduct research, analysis, data gathering, and issue investigations
Maintain vendor contract objectives, deliverables, roles, responsibilities, and performance documentation
Develop and maintain vendor dashboards, scorecards, issue logs, action-item trackers, and leadership reports
Engage vendors and cross-functional resources to resolve issues, escalate risks, and drive remediation
Manage and track vendor purchase orders, budgets, contracts, and delivered services
Review, validate, reconcile, and facilitate vendor invoice processing
Resolve invoice discrepancies with vendors and internal stakeholders
Track vendor spending, forecasts, actual activity, credits, penalties, recoveries, and other financial impacts
Identify cost-saving opportunities through invoice validation, utilization review, performance insights, and contract accountability
Coordinate multidisciplinary work across business areas, vendors, compliance, legal, product, technology, and operations
Contribute to business requirements, user stories, test scripts, production-readiness validation, and final business approval
Lead or support project management, meeting facilitation, agendas, pre-reads, minutes, and action-item follow-up
Analyze trends, root causes, business impacts, and operational risks to recommend corrective actions and process improvements
Provide management reports and consultation on vendor performance, financial performance, operational risks, and remediation progress
Facilitate education and communication regarding regulatory changes, vendor processes, compliance expectations, and operational impacts
Cultivate relationships with vendors, stakeholders, leadership, and cross-functional teams
Mentor or train team members on processes, documentation standards, tools, and regulatory or vendor-management expectations
Perform other duties as assigned

Requirements

What you’ll need

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
Experience supporting compliance, privacy, government programs, healthcare operations, legal matters, or regulatory deliverables
Bachelor’s degree in Business, Finance, Healthcare Operations, Healthcare Administration, or a related field
Advanced knowledge of ethical, corporate, or government compliance requirements or HIPAA privacy requirements
Intermediate PC proficiency
Intermediate proficiency with spreadsheet, database, presentation, and word-processing software
Strong analytical, interpersonal, verbal, and written communication skills
Ability to prioritize tasks and manage multiple priorities
Ability to interact professionally with executives, managers, subject matter experts, and diverse stakeholders
Ability to create and deliver employee education about complex government, corporate compliance, privacy, and ethical issues
Ability to maintain confidentiality and protect private information
Ability to generate reports from available data and make informed decisions
Ability to take appropriate, informed risks using available data
Ability to build synergy within a diverse team operating in a changing environment
Arizona residency and work performed within the State of Arizona
Required full-time work schedule of at least 40 hours per week
No required licenses or certifications

Benefits

Comp & perks

Hybrid Workability workforce strategy with flexibility in how and where employees work
Hybrid work opportunity within Arizona
Full-time schedule
Health insurance products and services offered by AZ Blue