OCI Integration Lead / Project Manager

Job Description Under broad supervision, manages projects through full life cycle from project definition through implementation of project deliverables. Creates collaborative partnership with all internal and external team members to accomplish the deliverables. Background: The State of is implementing a State-based Exchange (SBE), Access, to improve access to affordable, quality health insurance for . The go-live date for the SBE was November 1, 2024. The SBE is being implemented as a new division within the Office of the Commissioner of Insurance and Safety Fire (OCI). The goals of Access are to increase competition, innovation, and private sector investment in s market, improve the shopping and enrollment experience for consumers, and reduce the number of uninsured ns. Access is designed to enhance consumer choice by facilitating a more competitive marketplace with s private-sector partners providing innovative solutions for enrollment. Consumers will have the option to shop for, compare, and enroll in qualified health plans (QHPs) and stand-alone dental plans (SADPs) through certified web-brokers and health insurance carriers in addition to the state's consumer portal. Access will be the nation's first SBE that offers both private- and public-sector enrollment channels for consumers. The State will also certify Navigators and Certified Application Counselors (CACs) to provide consumer assistance. Access comprises various technology providers, partners, and interfaces. In the current plan, a contracted vendor will implement and maintain the Access Eligibility and Enrollment System as a SaaS product. The system will interface with federal and state systems, including the Federal Data Services Hub, CMS, IRS, and the State's Medicaid system. It will also interface with health insurance carriers and private sector partners for enrollment and shopping functionalities. Access must maintain compliance with HIPAA, PHI, and PII across all vendors and systems. Position Description: The Partner Integration Lead, a member of the SBE's Technology Department reporting to the Partner Integration Manager, is responsible for analyzing SBEs EDE (Enhanced Direct Enrollment) Partners policies, participating in inspections, and evaluating programs that integrate with the Access Eligibility & Enrollment System to provide a seamless consumer health insurance shopping experience from application to enrollment. The Project Manager will develop a deep understanding of all SBE functions and collaborate with the Business Technical Analyst to identify and meet emerging needs and opportunities for improvement. SBE staff, including the Project Manager, are expected to develop working knowledge of federal SBE requirements, reports, policies, systems, and regulations relevant to their roles. Local candidates only, as onsite work is required 3 days per week. Responsibilities: This role manages all aspects of CMS and EDE Partner-related coordination and activities, including annual partner Operational Readiness Reviews (ORRs), change management, system testing, insurance carrier backend processes, and partner compliance reviews. The responsibilities include, but are not limited to: Program Operations: Support the annual partner application process, including updates, reviews, and approvals. Support technical implementation for the Open Enrollment (OE) 2026 go-live on November 1, 2026, and ongoing. Support annual partner ORRs with assistance from the Eligibility and Policy Manager and the Information Security Officer. Manage review and approval of partner applications and technical change requests with support from other staff. Facilitate communication between internal teams, partners, and CMS, acting as the main point of contact for project inquiries. Maintain detailed records of partner applications, ORR status, and CMS change requests. Generate project status reports and update senior management. Coordinate reviews and approvals of partner applications, ensuring documentation is complete. Work with internal teams to manage communications and feedback during the application process. Host coordination meetings with cross-functional teams to ensure alignment. Monitor CMS changes to the EDE program and SBE requirements, coordinating with the Eligibility and Policy Manager on impact and adoption. Oversee partner documentation updates and review updates by analysts. Develop project scopes, objectives, and comprehensive documentation. Create project plans and visual tracking tools. Perform risk management and escalate issues as needed. Participate in crafting responses to major business issues. Stakeholder Engagement: Serve as the main contact for CMS and EDE partners, including program and technical questions. Facilitate meetings and discussions to drive decisions. Maintain relationships with third-party vendors and business partners. Manage relationships with internal clients and stakeholders. Education & Experience: Bachelor's degree and at least 6 years of relevant professional experience. A Master's degree may substitute for 2 years of experience. Knowledge & Skills: Strong background in managing technology implementation projects. Proficient in project management software (e.g., Microsoft Project, Jira).

#J-18808-Ljbffr