Health Insurance Exchange Transition Consultant

4 weeks ago

salem, United States OneAPPS Consulting Full time

OneAPPS is a Technology consulting firm based out of New York and offices across US. We are working on various projects involving diverse, multicultural teams with clients across the US. We are an invaluable partner and our teams have collaborated to support the growth of our clients. With more than 7 locations worldwide we help our clients to deliver their projects smoothly. We look forward to getting to know you and working with you.


Title: Health Insurance Exchange Transition Consultant

Location: Salem, OR – Part time HYBRID

Duration: 8 months with possible extensions


Our Client seeks an experienced Business Systems Consultant Manager IV to serve as a “Health Insurance Exchange Transition Consultant” who will provide technical expertise and guidance to the Client during this transition. This role requires in-depth knowledge of health insurance marketplace platform capabilities, CMS (Centers for Medicare & Medicaid Services) and IRS (Internal Revenue Service) security requirements, and the ability to review and recommend improvements to Request for Proposal (RFP) requirements.


Required skills and experience:

Bachelor's degree in a relevant field (e.g., Computer Science, Healthcare IT, or related).

Extensive experience (3+ years) in health insurance marketplace platforms, preferably with exposure to SBM go-live activities.

In-depth knowledge of CMS & IRS security requirements and compliance standards.

Proven experience in reviewing and revising RFPs and SLAs for complex technical projects.

Strong analytical and problem-solving skills, with the ability to make data-driven recommendations.

Excellent communication and interpersonal skills to work with diverse stakeholders.

Project management skills to ensure timely delivery of transition milestones.

Policy & standards analysis and implementation (7-9 years of experience)

Consolidation planning and management (10+years of experience)


Contractor’s Key Person under this WOC will provide expertise throughout the various phases of the project. Contractor’s Key Person shall be responsible for:


Platform Assessment: Evaluate the existing SBM-FP policies and identify technical capabilities, limitations, and areas for improvement. Understand the nuances of the CMS Federal Data Services Hub (FDSH) integration, and transition tasks and timelines.

CMS Security Compliance: Ensure that the transition adheres to CMS security requirements, including data protection, access controls, and privacy standards.

RFP Review: Analyze RFP documents related to the transition project, identifying gaps, ambiguities, and inconsistencies. Provide recommendations to align RFP requirements with best practices.

Service Level Agreements (SLAs): Assess and suggest enhancements to SLAs, ensuring that they are clear, measurable, and align with the Client's and CMS' expectations for the new SBE.

Technical Recommendations: Provide technical guidance and recommendations to enhance the Client's chosen SBM platform, optimizing its efficiency, scalability, and user-friendliness.

Stakeholder Collaboration: Collaborate with Client agencies, vendors, and CMS to facilitate a smooth transition process, addressing concerns and challenges effectively.

Documentation: Create comprehensive technical reports and documentation outlining the transition plan, security measures, RFP revisions, and SLA recommendations.


If this role sounds like you, we invite you to apply. Thanks.

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