Business Subject Matter Expert

Job Title

The Office of Information Services (OIS) is a shared service provider for the Oregon Health Authority (OHA) and Oregon Client (ODHS). OIS provides the technology systems and services that support more than 18,000 OHA and ODHS agency staff at local offices and facilities around Oregon. These systems and services help the two agencies determine client service program eligibility; provide medical, housing, food, and job assistance; provide addiction, mental health, vocational and rehabilitative services; protect children, seniors and people with physical and/or developmental disabilities; process claims and benefits; manage provider licensing and Oregon hospital facilities; and promote and protect the Oregon public health.

Senate Bill (SB) 972 requires OHA to transition the Oregon Health Insurance Marketplace (OHIM) from a state-based marketplace using the federal platform (SBM-FP) to a state-based marketplace (SBM) using its own technology in time for open enrollment for plan year 2027. Specifically, OHA is required to procure and administer an information technology platform or service and call center, separate from the federal platform and call center, to provide electronic access to the health insurance marketplace in this state by November 1, 2026.

Scope of Work:

The Oregon Health Authority OHIM seeks an experienced UAT Business Subject Matter Expert Tester to support the SB 972 Transition Project as Oregon moves from an SBM FP to a full State Based Marketplace (SBM). Contractor's Key Person shall work closely with Marketplace business partners, GetInsured, Medicaid/ONE system teams, and technical teams to ensure the new marketplace platform meets business needs, supports compliance, and delivers accurate, high-quality functionality. Contractor's Key person shall provide advanced user acceptance testing support for the development and implementation of Oregon's new StateBased Marketplace (SBM). Contractor's Key Person shall ensure that eligibility, enrollment, and Marketplace operations systems meet business needs, align with policy, and function correctly for consumers, partners, and programs. Contractor's Key Person shall collaborate closely with Marketplace business partners, product staff, technical teams, the Oregon Health Insurance Marketplace's vendor GetInsured, and Oregon's Medicaid division—specifically the teams supporting the ONE eligibility system to design, execute, and validate UAT activities in both agile and traditional delivery environments. Contractor's Key Person shall serve as a subject matter expert in test design, test execution, defect analysis, and continuous improvement of testing processes.

Tasks:

• Contractor's Key Person shall:
• Review and analyze project requirements, user stories, use cases, process flows, and acceptance criteria for clarity, completeness, and testability.
• Maintain and update the requirements traceability matrix (RTM).
• Create, update, and maintain UAT test cases, scenarios, test data, and test suites.
• Contribute to UAT test plans outlining testing scope, approach, environments, schedule, resources, and risks.
• Execute manual UAT test cases and document detailed results, including evidence, discrepancies, and validation outcomes.
• Participate in test case review sessions and identify automation candidates for collaboration with automation engineers.
• Support regression testing and verify defect fixes to ensure system stability.
• Support exploratory testing, targeted bug hunts, and ad hoc validation activities.
• Log defects with clear reproduction steps, supporting documentation, and expected behavior; retest defects and confirm resolution. Using JIRA as provided by GI for logging defects.
• Perform or support integration testing across systems, APIs, services, and interfaces affecting Marketplace operations.
• Contribute to or support load, performance, security, and accessibility testing.
• Prepare, request, or curate test data required for UAT cycles.
• Validate UAT readiness including requirements, environments, tools, and data availability.
• Participate in defect triage, contributing to assessments of priority, severity, and business impact.
• Provide guidance, coaching, and support to business SMEs participating in UAT.
• Develop and maintain UAT best practices, documentation, templates, and training materials.
• Provide daily/weekly test metrics, summaries, and progress updates to program leadership.
• Fully participate in Scrum ceremonies (If applicable) including planning, refinement, standups, demos, and retrospectives.
• Contribute to release readiness assessments and go/no go recommendations.
• Learn and apply basic automation concepts and collaborate with automation engineers where applicable.
• Identify continuous improvement opportunities for UAT processes, tools, and cross team collaboration.
• Serve as a Business SME Tester responsible for validating system behavior from an end to end business perspective.
• Develop user acceptance test cases,
• Execute testing
• Ensure that system outputs align with Marketplace policy, operational workflows, and federal and state regulations.

Required Skills and Experience:

• Strong understanding of UAT methodologies, SDLC, and Agile/Scrum frameworks.
• Ability to analyze business and technical requirements and translate them into effective test cases.
• Experience designing and executing complex test scenarios.
• Proficiency using test management and defect tracking tools (Azure DevOps, Jira, etc.).
• Strong analytical and problem solving skills.
• Excellent communication skills for both technical and non technical audiences.
• Ability to prioritize work, manage time effectively, and operate with limited supervision.
• Understanding of accessibility standards (WCAG), security testing fundamentals, and performance considerations.
• Ability to identify risks and propose mitigation strategies. Strong interpersonal and collaborative skills.
• Marketplace domain expertise:
• Deep understanding of Health Insurance Exchange (HIX) operations, including differences between SBMs and SBM FPs.
• Experience supporting Oregon's current SBM FP environment and the ability to translate that knowledge to the upcoming SBM model.
• Strong knowledge of ACA Marketplace policy, including eligibility, enrollment, plan management, account transfers, redeterminations, and consumer assistance.
• Advanced understanding of Marketplace interactions with state Medicaid systems, including MAGI rules, account transfers, coordinated eligibility, and data exchange requirements.
• Understanding of Marketplace impacts on carriers, assister programs, enrollment partners, and call center operations.
• Ability to convert Marketplace policy, CMS guidance, and regulatory requirements into system rules, business logic, and UAT test scenarios.

In addition, the ideal candidate will have skills and experience in:

• Experience working in a Health Insurance Exchange (HIX) environment, including experience within Oregon's current StateBased Marketplace using the Federal Platform (SBMFP) or experience working in a fully StateBased Marketplace (SBM).
• Advanced understanding of Marketplace operations including eligibility, enrollment workflows, plan management, account transfers, redeterminations, and consumer assistance functions.
• Experience supporting or integrating Marketplace operations with a state Medicaid system, including MAGI based eligibility, account transfers, and coordinated eligibility processes.
• Advanced understanding of ACA rules and regulations including APTC/CSR eligibility, enrollment rules, special enrollment periods, and federal reporting/compliance requirements.
• Familiarity with test automation frameworks (Selenium, Playwright, Robot Framework, etc.).
• Experience preparing or managing complex test data sets.
• Background or training in business analysis or broader QA disciplines beyond UAT.

Working Conditions:

• Remote setting following agency policy.
• Workload may increase during release cycles and major project milestones.
• Requires coordination with cross functional teams across OHA, OIS, carriers, assister networks, contractors, and vendor partners.
• May require occasional extended hours during critical production cycles.

Covendis rate card description for a Business Subject Matter Expert: Provide proven, specialized experience from related businesses or organizations as well as system integration and technology experience. Expertise could include various technologies and roles, including SME in product and software or functional areas. Bachelor's degree with 10 + years' experience in computer science, IT, or related field. 10 years' proven experience in a variety of technologies and roles, including SME in product and software or functional areas. This role encompasses working with Mid and Senior management and stakeholders in an organization. Covendis rate card rates for a Business Subject Matter Expert: Our primary criteria are the qualifications and experience of the proposed key person. Please propose your strongest candidate, at a rate less than or