Position Description
Serco is seekinga self-motivated Policy Operations Manager to join our talented and fast-paced team supporting millions of people applying for healthcare coverage via the Federal Facilitated Marketplace (Marketplace). This dynamic Advisory Services position on the CMS Eligibility Support (ES) Contract will provide thought leadership and manage the development and transformation of processes and systems that review, adjudicate, and assist consumer applications. As such, the candidate in this role will closely collaborate with Serco Leadership; Service Delivery, IT Solutions and Delivery; and Operations teams; and CMS Executives.
The candidate in this position ideally brings the unique combination of subject matter expertise in federal health insurance eligibility policy, particularly for the Health Insurance Marketplace and Medicaid, as well as business and technical understanding of eligibility and enrollment processes to coordinate and optimize multiple aspects of verification operations.The candidate in this position will lead the strategic planning, business process design, and operationalizing policy changes across functional teams to ensure optimal project management and delivery.
This role is primarily located in Serco's Herndon, VA office with hybrid telework options possible.
In this role, you will:
Advise as a subject matter expert on CMS and its health programs' (including Marketplace, Medicare, and Medicaid) eligibility and enrollment policy and operations to strategically improve Marketplace eligibility verification. This includes:
Providing in-depth analysis and recommendations regarding health insurance and coverage policy changes that would impact Marketplace eligibility verification and consumers applying for health insurance through the Marketplace.
Leveraging knowledge and expertise to strategically align business policy, processes and operations in implementation of new or changed program policy or guidance to ensure optimal consumer experience.
Guiding ES verification leadership and teams (business, operations, quality, and systems teams) on program requirements for implementing new policy and/or process improvements for enhanced consumer outcomes.
Drive thought leadership in initiating and developing strategic planning and program improvements initiatives that would optimize Marketplace eligibility processing and enhance consumer enrollment outcome through consumer-centered design.
Lead as key senior project manager to ensure successful delivery of program policy and business process change implementation. This includes:
Collaboratively designing project proposals' vision, objectives, and implementation requirements and roadmap.
Communicating value and risk of proposals through briefings and white papers.
Managing and coordinating priority projects that crosscut multiple teams and product lines.
Analyzing and reviewing business, functional, and technical requirements; draft operational plans and documentation (SOPs, trainings, work instructions, etc.); and develop performance analytics.
Guiding and mentoring teams through project management and documentation processes.
Serve as trusted advisor and liaison to CMS in delivering executive level communication and consultation to CMS and Serco. This includes:
Building and maintaining effective and efficient collaborative working relationships with the client, interfacing with government SMEs and stakeholders, and Serco teams.
Deliver strategic written and oral briefings at the appropriate detail level to ES and Serco Leadership with clear and concise descriptions on policy and/or program changes including options, requirements, and potential risk and impact.
Collaboratively produce high-level, well-written memos, briefs, analysis, evaluations, reports and presentations.
Engage Serco leadership and team on policy and program changes through memos, newsletters, and briefings.
Perform other tasks as required or assigned.
Qualifications
To be successful in this role, you will have:
Bachelor's degree or higher in public health, public administration, government or public policy, or other appropriate advanced degree required.
Minimum ten years' experience in implementing or administering health coverage programs with focus on consumer-centered processes (e.g. application assistance, eligibility verification, call center, advance casework; OR
Minimum ten years of experience performing complex legislative, regulatory and program analyses and/or research on government health programs (such as Marketplace, Medicaid, CHIP, and Medicare) and/or private health insurance.
Expertise in understanding of CMS and its Federal Marketplace eligibility and enrollment policies, processes, and operations.
Understanding of ACA and Marketplace policy issues affecting consumer coverage.
Well-versed in Marketplace legislative, regulatory, and sub-regulatory guidance.
Knowledge of other federal health programs (such as Medicaid, Children's Health Insurance Program and Medicare) and private health insurance industry.
Expertise in implementing eligibility and enrollment policies, programs, processes, and improvement initiatives. This includes understanding business process design, operational impacts, IT system requirements and integration, and consumer impacts.
Highly adept at managing large and/or complex projects, tasks, and workstreams to support healthcare stakeholders with policy, operational, system, and IT support.
Strong experience in designing and analyzing program production and performance data to understand program impact and solution improvement actions.
Demonstrated good judgment, a well-developed sense of propriety, political acumen, the ability tothink constructively.
Strong leadership and organizational skills.
Exceptional interpersonal and Client management skills.
Strong verbal and written communications skills.
Ability to deal with complex and changing policy and political environment.
Enjoy working in fast-paced and collaborative team environment
Company Overview
Serco Inc. (Serco) is the Americas division of Serco Group, plc. Serco serves every branch of the U.S. military, numerous U.S. Federal civilian agencies, the Intelligence Community, the Canadian government, state and local governments, and commercial clients. We help our clients deliver vital services more efficiently while increasing the satisfaction of their end customers. Headquartered in Herndon, Virginia, Serco Americas has over 9,000 employees and is part of a $4 billion global business that helps transform government and public services around the world. At Serco, our employees are our most valuable asset - we listen, respect and support them throughout their career at Serco. We invite you to become part of our dynamic team. Serco is an equal opportunity employer committed to diversifying our workforce (Race/ Color/ Sex/ Sexual Orientation/ Gender Identity/ Religion/ National Origin/ Disability/ Vets).
To review Serco benefits please visit: https://www.serco.com/na/careers/benefits-of-choosing-serco .
If you require an accommodation with the application process please email: careers@serco-na.com or call the HR Service Desk at 800-628-6458, option 1. Please note, due to EEOC/OFCCP compliance, Serco is unable to accept resumes by email.
Serco does not accept unsolicited resumes through or from search firms or staffing agencies without being a contracted approved vendor. All unsolicited resumes will be considered the property of Serco and will not be obligated to pay a placement or contract fee. If you are interested in becoming an approved vendor at Serco, please email Agencies@serco-na.com .
COVID-19 Regulations: Serco complies with all applicable COVID-19 requirements. This may require employees to be vaccinated against COVID-19, provide attestations regarding vaccination status and/or COVID-19 testing, or satisfy other conditions of employment that Serco deems appropriate, and employees may be required to show proof of vaccination and/or negative COVID-19 test results as a condition of employment (except in limited circumstances where an employee is legally entitled to an accommodation).
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ID 51704
Recruiting Location : Location US-VA-Herndon
Category Business Systems/Analysis
Position Type Full-Time
Security Clearance None
Telework Yes - May Consider Occasional/Part Time Teleworking for this position
