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Marketplace Domain Subject Matter Expert (SME)

4 months, 3 weeks ago
United States, Canada
Full-time
Senior
Business Analyst
Customer and Technical Support
Apply Now
CWS

CWS

CWS Computer World Services Corp. is a leading IT service provider specializing in digital transformation and high-end IT services for the federal market, offering innovative solutions and quality services to government clients worldwide.

IT Services
251-1K
Founded 1990
View All Jobs 4

Description

  • Serve as the primary subject matter authority on ACA/PPACA policy, regulation, and CCIIO program operations for the MSD team.
  • Monitor annual NBPP, plan year guidance, and CCIIO policy updates and brief operations staff on changes affecting service desk scope.
  • Provide expert guidance on QHP certification cycle requirements, issuer obligations, and CMS-issuer relationship management.
  • Support Tier 2 and Tier 3 escalation resolution for complex policy, regulatory, and plan management inquiries.
  • Lead development and maintenance of the MSD knowledge base, ensuring articles and supporting materials remain accurate and current.
  • Author and review Tier 1–3 resolution guides, SOPs, and escalation playbooks for Marketplace issue categories.
  • Coordinate with AI and automation tools teams to keep triage bots and self-service content aligned with current Marketplace guidance.
  • Design and deliver Marketplace domain training, mentorship, and plan-year refresher materials for customer service representatives and senior analysts.
  • Support issuer communications, onboarding, and annual QHP certification cycle outreach.
  • Contribute to CMS-facing deliverables such as monthly reports, escalation summaries, continuous improvement recommendations, and briefing materials.

Requirements

  • Bachelor’s degree in health policy, public administration, public health, business administration, information technology, or a related field.
  • Minimum 5 years of direct experience supporting CMS CCIIO Marketplace operations, QHP certification, issuer relations, or ACA plan management.
  • Direct experience on the CMS Marketplace Service Desk (MSD) or a closely adjacent CCIIO program.
  • Demonstrated expertise in QHP certification processes, including HIOS/MPMS submission workflows, plan management requirements, and issuer compliance obligations.
  • Experience developing or maintaining knowledge management content, SOPs, or training materials in a federal help desk or program support environment.
  • Excellent written and verbal communication skills, with experience preparing federal deliverables, briefings, or policy documents.
  • In-depth knowledge of HIOS, MPMS, and/or SERFF as used in the QHP certification process.
  • Familiarity with CMS Marketplace Quality Initiatives, including QRS, the QHP Enrollee Survey, and QIS.
  • Working knowledge of ACA/PPACA statute, associated federal regulations, and annual CCIIO guidance documents.
  • Must be able to obtain a federal Public Trust, Moderate Background Investigation (MBI), or higher clearance.
  • Ability to work Eastern Time Zone hours, including flexible scheduling during open enrollment surge periods from October to January.
  • Preferred: prior key personnel designation on a CMS or federal health IT service desk contract.
  • Preferred: experience with ITSM platforms such as ServiceNow or equivalent in a federal service desk environment.
  • Preferred: experience with AI-assisted knowledge management tools or chatbot/virtual agent content development.
  • Preferred: established relationships within the CCIIO/Marketplace contractor or federal program community.
  • Preferred: PMP, ITIL Foundation, or equivalent project/service management certification.

Benefits

  • Competitive salary of $145,000 to $205,000 per year, based on experience and qualifications.
  • Remote/telework work arrangement with occasional work at CMS CCIIO in Baltimore, MD.
  • Flexible scheduling during open enrollment surge periods.
  • Potential travel opportunities for meetings in the Baltimore, MD and/or Washington, DC areas.
  • Reasonable accommodations for individuals with disabilities.
  • Equal employment opportunity and affirmative action employer status.
  • Human review of hiring decisions, with AI used only to support parts of the recruitment process.

Interested in this position?

Apply directly on the company website

Apply Now

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