Role: ACA Enrollment & Membership Solutions Consultant
Location – Jefferson City, MO (On-site)
Contract
Required Experience:
· 10–15+ years of experience in ACA healthcare software product development.
· 8+ years in Product Management, Senior Business Analysis, Product Ownership, or Solution Architecture.
· Proven experience building or enhancing commercial healthcare software products (not implementation-only experience).
· Strong understanding of end-to-end ACA eligibility, enrollment, and membership administration processes.
Functional Expertise:
Candidates should demonstrate expertise in:
· ACA Eligibility & Enrollment
· Individual & Family Marketplace Products
· Small Group Enrollment
· Federal Marketplace
· State-Based Marketplaces
· Enhanced Direct Enrollment
· Open Enrollment & Special Enrollment Periods
· Qualified Health Plans
· APTC & Cost Sharing Reduction
· Membership Lifecycle Management
· Plan Administration
· Broker & Agency Enrollment
· Premium Billing Integration
· Member Services
Integration & EDI Knowledge
Strong understanding of healthcare integrations including:
· 834 Enrollment
· 820 Premium Payment
· 270/271 Eligibility Verification
· 999/277 Acknowledgements
· REST APIs and modern integration patterns
Preferred Qualifications:
· Bachelor's degree in Computer Science, Information Systems, Healthcare Administration, Business, or a related field.
· Experience working with ACA health plans, regional Blues, Medicaid Managed Care Organizations, or national payers.
· Familiarity with cloud-native, API-first product architectures and AI-driven healthcare solutions.