Job Title: Business Analyst
Job Location: Downers Grove, IL
Job Duration: 4 Months (possibility of extension)
Payrate: $35.47/ hr. on w2
Hybrid schedule- 3 days in office, 2 days WFH. Candidates must have their own equipment to WFH. Otherwise will need to be fully onsite.
This is set up for B-Flex time entry not SPARK.
Job Summary:
- The Business Analyst will support oversight, monitoring, and compliance activities related to ACA Marketplace brokers.
- This role ensures adherence to CMS regulations, internal policies, and contractual requirements governing broker activities.
- The analyst will leverage established processes, policies, procedures, reporting, and cross-functional collaboration to identify risks, monitor broker performance, and perform audit activities to support compliance efforts.
- The ideal candidate needs to be a result-oriented person that can work autonomously towards achieving the desired goals.
- In addition, this candidate will need to possess the highest level of integrity and the desire to always do what is right.
Key Responsibilities:
Broker Monitoring & Oversight:
- Maintain and enhance monitoring frameworks for ACA Marketplace broker activity (e.g., enrollments, switching patterns, consumer complaints).
- Analyze broker behavior to identify potential non-compliant or fraudulent activity, including unauthorized enrollments or rapid disenrollment trends.
- Partner with sales, compliance, and operations teams to investigate flagged broker activity.
Compliance & Regulatory Support:
- Ensure alignment with CMS, state DOI, and Affordable Care Act (ACA) regulations related to broker engagement.
- Support audits and regulatory inquiries by gathering documentation and evidence while performing broker outreach activities.
- Assist in the creation and maintenance of policies, procedures, and controls for broker oversight programs.
Reporting & Data Analysis:
- Perform outreach and analysis on complaints, grievances, and enrollment activity tied to brokers.
- Build and maintain dashboards and reports to track broker performance and compliance metrics.
- Provide actionable insights and recommendations to leadership to mitigate risk and improve compliance.
Complaint & Issue Management:
- Lead and support remediation actions, including broker warnings, retraining, suspension, or termination activities.
- Track and trend complaint data to identify systemic issues or high-risk brokers.
Process Improvement:
- Identify opportunities to strengthen broker compliance monitoring processes and tools.
Stakeholder Collaboration:
- Act as a liaison between compliance, sales, operations, and legal teams.
- Document and present findings and recommendations to internal stakeholders and leadership.
- Support broker relations teams with compliance education and performance feedback.
Fundamental Job Requirements:
- Bachelor’s degree.
- Experience in the health insurance industry.
- Fluent in Spanish, ability to translate Spanish to English.
- Personal laptop that can be used for work.
- Proficient in MS Office (Word, Excel, etc).
- Solid communicator, written and verbal.
- Detail oriented.
- Strong organizational skills.
- Adaptable.
- Team player that works well in a team environment.
- Willingness to step in and step up based on the demand of the job.
- Curious, having the want and willingness to dig in and ask questions.
Preferred Job Requirements:
- Experience in the health insurance industry.
- Fluent in Spanish, ability to translate Spanish to English.
