Senior Business Systems Consultant

5 days ago

Salem, Oregon, United States Mavensoft Technologies Full time

Job Title: Sr. Business Systems Analyst - Medicare and Health Insurance

Key Skills: Health insurance marketplace expertise, CMS & IRS security compliance, RFP and SLA review, Analytical and problem-solving skills, Communication and interpersonal skills, Project management, Policy and standards analysis and Consolidation planning and management

Job Summary: Mavensoft Technologies seeks an experienced Business Systems Consultant Manager IV to serve as a Health Insurance Exchange Transition Consultant who will provide technical expertise and guidance 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.

Key Responsibilities:

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 state's and CMS' expectations for the new SBE.

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

Stakeholder Collaboration: Collaborate with state 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.

Requirements:

  • 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)

About Mavensoft Technologies: Mavensoft Technologies is a leading provider of healthcare technology solutions. We are committed to delivering high-quality services that meet the evolving needs of our clients. If you are a motivated and experienced professional looking for a new challenge, we encourage you to apply for this exciting opportunity.

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