Business Systems Consultant Manager IV

Job:Business Systems Consultant Manager IV

Location : Salem Oregon (REMOTE)

Duration: Long Term Contract

Client is a shared service provider for the Oregon Health Authority (OHA) and client. OIS provides the technology systems and services that support more than 18000 OHA and client agency staff at local offices and facilities around the state. 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 state hospital facilities; and promote and protect the state public health.

SB 972 requires OHA to transition the Oregon Health Insurance Marketplace (OHIM) from a statebased marketplace using the federal platform (SBMFP) to a statebased 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.

OIS 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 state of Oregon during this transition. This role requires indepth 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.

1. Contractors Key Person under this WOC will provide expertise throughout the various phases of the project. Contractors Key Person shall be responsible for:
2. Platform Assessment: Evaluate the existing SBMFP 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.
3. CMS Security Compliance: Ensure that the transition adheres to CMS security requirements including data protection access controls and privacy standards.
4. RFP Review: Analyze RFP documents related to the transition project identifying gaps ambiguities and inconsistencies. Provide recommendations to align RFP requirements with best practices.
5. Service Level Agreements (SLAs): Assess and suggest enhancements to SLAs ensuring that they are clear measurable and align with the states and CMS expectations for the new SBE.
6. Technical Recommendations: Provide technical guidance and recommendations to enhance the states chosen SBM platform optimizing its efficiency scalability and userfriendliness.
7. Stakeholder Collaboration: Collaborate with state agencies vendors and CMS to facilitate a smooth transition process addressing concerns and challenges effectively.
8. Documentation: Create comprehensive technical reports and documentation outlining the transition plan security measures RFP revisions and SLA recommendations.

Required skills and experience:

• Bachelors 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 golive activities.
• Indepth 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 problemsolving skills with the ability to make datadriven 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 (79 years of experience)
• Consolidation planning and management (10years of experience)