Policy & Implementation Specialist

Policy & Implementation Specialist

Serco is seeking a motivated and results driven Policy & Implementation Specialist to shape and drive strategic policy and operations initiatives. The candidate would join our talented and fast-paced team supporting millions of people applying for healthcare coverage via the Affordable Care Act (ACA) Health Insurance Marketplace (Marketplace). This dynamic position will provide thought leadership and management to implement policy and program changes for 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 ACA knowledge, subject matter expertise in health insurance markets trends, and federal and state health insurance policies and programs (such as the ACA Marketplaces, Medicaid/CHIP and Medicare), as well as technical understanding of eligibility and enrollment processes to coordinate and optimize multiple aspects of verification operations.

Responsibilities:

• Advise on health and insurance policies, program changes, and market trends that would impact CMS programs, especially the ACA Marketplace eligibility and enrollment operations
• Monitor health policy-related guidance, regulations, and legislation
• Research, analyze and report on market and insurance coverage trends
• Stay abreast of CMS programs and latest analysis, research, evaluations, and reports from government, industry, think tanks, and advocacy organizations
• Use research and monitoring to proactively identify potential changes that may impact consumers applying for health insurance through the Marketplace, provide analysis and recommendations as appropriate
• Serve as an ACA policy expert integrating knowledge of Marketplace eligibility and enrollment policy into the Marketplace verification process and operations
• Support leadership and teams (business, operations, and systems teams) on eligibility requirements as policy changes or processes are improved or enhanced
• Incorporate policy changes and operationalize new or revised guidance
• Manage and/or coordinate priority projects that crosscut multiple teams and product lines to analyze business, functional, and technical requirements; draft operational plans and documentation; develop performance analytics; and track and meet deliverable schedules
• Perform liaison role delivering executive level communication and consultation
• Deliver strategic written and oral briefings to CMS and Serco Leadership with clear and concise descriptions on policy and/or program changes including options, requirements, and potential impacts
• Communicate key policy changes to CMS and Serco teams through storytelling in detailed, well-written memos, briefs, analysis, evaluations, reports and presentations
• Develop and maintain effective and efficient working relationships with the Client, interfacing with government SMEs and Serco teams
• Contribute to business development efforts to accelerate growth
• Identify and pursue potential business opportunities that align with Serco's objectives and capabilities
• Provide policy, implementation, and innovation expertise in drafting responses to sources sought, request for proposals, and other business development requirements

To be successful in this role, you must have:

• Bachelor's degree in relevant field, e.g. public health, health administration, government, or law or other appropriate degree required
• Minimum eight year's project management experience for complex government program
• Minimum eight years' experience providing ACA Health Insurance Marketplace policy expertise in government or advocacy organization; OR Minimum five years of experience performing legislative, regulatory and program analyses and/or research on government health programs (such as Marketplace, Medicaid, CHIP, and Medicare) and/or private health insurance
• Demonstrated knowledge of the Marketplace eligibility and enrollment policies and processes, or other federal health programs (such as Medicaid, Children's Health Insurance Program or Medicare) and private health insurance industry
• Ability to travel up to 10% of the time

Desired Skills:

• Expertise in Affordable Care Act legislative, regulatory and sub-regulatory guidance
• Well-versed on the Marketplace eligibility and enrollment processes and the operations that support verifications
• Knowledge of other federal health programs (such as Medicaid, Children's Health Insurance Program and Medicare) and private health insurance industry
• Understanding of ACA and Marketplace policy issues affecting consumer coverage
• Demonstrated capabilities in qualitative and quantitative research and analysis, especially related to CMS programs
• Ability to navigate with complex and changing policy and political environment
• Strong leadership and organizational skills
• Exceptional interpersonal and Client management skills
• Strong verbal and written communications skills