The ARDX Healthcare Policy Consultant will act as a trusted advisor to federal government customers in support of the Affordable Care Act (ACA) Marketplaces (Exchange) program operations. Consultants possess strong knowledge of regulatory and legislative US healthcare policy including the ACA and the No Surprises Act (NSA) and their operations. Consultants support the Centers for Medicare & Medicaid Services (CMS) program outreach and training needs to ensure stakeholder regulatory compliance. Our ideal candidate has a passion for supporting programs that enable affordable health care for millions of Americans and advancements in health equity.

Duties:

• Serve as client’s architect and expert for planning and implementation of programs including stakeholder training and outreach based on program goals and needs. Stakeholders may include Health Plans, Agent/Brokers, States, Associations, Navigators/Assisters, Third Party Administrators (TPAs), and Pharmacy Benefit Managers (PBMs).
• Develop and implement outreach strategy which includes collecting requirements, developing an approach roadmap, and delivering products that meet or exceed client's expectations.
• Act as the client’s partner to develop and manage solutions to meet program needs, address program challenges, and make informed decisions.
• Serve as a program policy operational expert. Programs may include Plan Management, Enrollment & Eligibility, Risk Adjustment, Distributed Data Collection (EDGE server), Cost Sharing Reductions (CSRs), Qualified Health Plans (QHPs), Small Business Health Options Program (SHOP), and Enhanced Direct Enrollment (EDE).
• Analyze requirements and engage in collaborative reviews with the client to affirm assumptions, timelines, and deliverables and manage outcomes based on project management and consulting best practices by displaying project management expertise.
• Research and develop meaningful guidance in the form of training materials, job aids, manuals, operational documents, and digital training solutions.
• Maintain awareness of current policy and regulations and proactively identify downstream impacts and solutions.
• Plan and facilitate client meetings, webinars, and onsite conferences.
• Draft and update policy and operational documentation including Standard Operating Procedures (SOPs) and develop White Papers.
• Analyze stakeholder questions and feedback to identify knowledge gaps, pain points, and opportunities for outreach.
• Bridge the gap between policy and operations by effectively recommending appropriate, efficient, and innovative solutions for issues and challenges.
• Serves as a partner and strategist for solutions to complex challenges and execute with excellence under tight delivery timeframes.
• Follow quality procedures to ensure the accuracy, quality, and timeliness of all deliverables.
• Develop strong client relationships and trust in ARDX.
• Perform other duties as assigned.

• Bachelor’s degree required; master’s degree preferred in Public Health, Public Policy, Public Administration or Healthcare Administration
• 3 years of healthcare working experience related to policy development, regulatory compliance, or quality improvement
• Experience with federal healthcare programs (i.e., ACA Marketplaces, Medicaid, Medicare, or No Surprises Act)
• Technical writing and curriculum development
• Experience conducting independent research
• Experience documenting and following standard operating procedures (SOPs) with ability to follow step-to-step instructions and identify process improvements
• Written and oral communication skills
• Analytical skills
• Experience interpreting federal and/or state regulations
• Experience working in a fast-paced, entrepreneurial environment
• Interpersonal skills
• Organizational and time-management skills
• Client relationship management skills
• Proficiency using Adobe and Microsoft Office applications such as Excel, Word, PowerPoint, Outlook, and Teams

Preferred Qualifications:

• Experience facilitating webinars or large meetings (including virtually via Zoom, Microsoft Teams, or other virtual platform)
• Experience working with the Centers for Medicare & Medicaid Services (CMS)
• Experience working with state health/regulatory agencies, health plans, navigators/assistors or issuer vendors
• Experience conducting research on healthcare policies and industry trends
• Experience with federal government contracting
• Experience in a client-facing consulting role
• Project Management Professional (PMP®) certification
• Experience with Jira and Confluence
• Experience working in an organization with an ISO certification and/or CMMI appraisal rating
• Experience working for an ESOP

EEO AA/Minority/Female/Veteran/Disability