Policy and Implementation Specialist

Serco Group-posted 9 days ago

Full-time • Mid Level

Hybrid • Herndon, VA

5,001-10,000 employees

Administrative and Support Services

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Serco is seeking a motivated and results driven health policy advisor 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 subject matter expertise in health insurance markets trends, 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. This role is primarily located in Serco's Herndon, VA office with possibility of telework options.

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
Proactively identify potential changes that impact consumer applying for health insurance through the Marketplace and provide in-depth analysis and recommendations
Develop strategic planning and program improvements initiatives that would optimize Marketplace eligibility processing and enhance consumer enrollment outcomes
Serve as an eligibility and enrollment policy subject matter expert integrating knowledge of the eligibility policy to Marketplace verification program 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; and develop performance analytics
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 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
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
Performs other tasks as required or assigned

Bachelor's degree in relevant field, e.g. public health, health administration, government, or law or other appropriate degree required
Minimum five year's project management experience for complex government program
Minimum five 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

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

Medical, dental, and vision insurance
Robust vacation and sick leave benefits, and flexible work arrangements where permitted by role or contract
401(k) plan that includes employer matching funds
Tuition reimbursement program
Life insurance and disability coverage
Optional coverages you can buy, including pet insurance, home and auto insurance, additional life and accident insurance, critical illness insurance, group legal, ID theft protection
Birth, adoption, parental leave benefits
Employee Assistance Plan that includes counseling conditions

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