Subject Matter Expert

Summary

CWS is pursuing the CMS Marketplace Service Desk (MSD)opportunity. The MSD supports the Center for Consumer Information and Insurance Oversight (CCIIO) by providing technicalassistanceto issuers, agents and brokers, Application Development Organizations (ADOs), state agencies, and otherAffordable Care Act (ACA)Marketplace stakeholders.The Marketplace Domain SME is a key position responsible for providing deep subject matterexpertisein the ACA Health Insurance Marketplace, Qualified Health Plan (QHP) certification, and CCIIO program operations. This individual will serve as the resident domain authority forourMSD team — ensuring service desk operations, knowledge management content, training curricula, and stakeholder communications reflectaccurate, current Marketplace policy and regulatory knowledge.Key Tasks & ResponsibilitiesMarketplace Domain Expertise and AdvisoryServe as the MSD team's primary subject matter authority on ACA/ Patient Protection and ACA (PPACA) policy, regulation, and CCIIO program operationsMonitor and interpret annual Notice of Benefit and Payment Parameters (NBPP), plan year guidance, and CCIIO policy updates; brief operations staff on changes affecting MSD scopeProvideexpert guidance on QHP certification cycle requirements, issuer obligations, and CMS-issuer relationship managementSupport Tier 2 and Tier 3 escalation resolution for complex policy, regulatory, and plan management inquiriesKnowledge ManagementLead development and maintenance of the MSD knowledge base, ensuring accuracy and currency of articlesand related materialsAuthor and review Tier 1–3 resolution guides, Standard Operating Procedures (SOP), and escalation playbooks for Marketplace-specific issue categoriesEnsure knowledge base content reflects current plan year policies, system changes, and issuer/agent-broker guidanceCoordinate with AI/automation tools team to ensure triage bots and self-service content accurately reflect current Marketplace guidanceTraining and Staff DevelopmentDesign and deliver Marketplace domain trainingand mentorshipfor MSD Customer Service Representatives and SeniorAnalystsonboarding and annually for plan year refreshersand surge-readiness training materialsStakeholder and Account Management SupportSupport Account Manager in issuer communications, onboarding, and annual QHP certification cycle outreachContribute domainexpertiseto CMS-facing deliverables including monthly reports, escalation summaries, and continuous improvement recommendationsAssistin preparing CMS briefings on Marketplace issue trends, emerging policy questions, and stakeholder feedback patternsEducation & Experience EducationBachelor's degree required in health policy, public administration, public health, business administration, information technology, or a related fieldExperienceMinimum 5 years of direct experience supporting CMS CCIIO Marketplace operations, QHP certification, issuer relations, or ACA plan managementDirect experience on the CMS Marketplace Service Desk (MSD) or a closely adjacent CCIIO programDemonstratedexpertisein QHP certification processes, including HIOS/MPMS submission workflows, plan management requirements, and issuer compliance obligationsExperience developing ormaintainingknowledge management content, SOPs, or training materials in a federal help desk or program support environmentExcellent written and verbal communication skills; experience preparing federal deliverables, briefings, or policy documentsTechnical KnowledgeIn-depth knowledge of HIOS (Health Insurance Oversight System), MPMS (Marketplace Plan Management System), and/or SERFF as used in the QHP certification processFamiliarity with CMS Marketplace Quality Initiatives: Quality Rating System (QRS), QHP Enrollee Survey, and Quality Improvement Strategy (QIS)Working knowledge of ACA/PPACA statute, associated federal regulations, and annual CCIIO guidance documentsUnderstanding of CCIIO stakeholder ecosystemPreferredQualificationsPrior key personnel designation on a CMS or federal health IT service desk contractExperience with ITSM platforms (ServiceNow or equivalent) in a federal service desk environmentExperience with AI-assisted knowledge management tools or chatbot/virtual agent content developmentEstablished relationships within the CCIIO/Marketplace contractor or federal program communityCertificationsPMP, ITIL Foundation, or equivalent project/service management certificationpreferredSecurity ClearanceMust be able to obtain a federal Public Trust , Moderate Background Investigation (MBI ), or higher clearanceOther (Travel, Work Environment, DoD 8570 Requirements, Administrative Notes, etc.)Remote / Telework with occasional work at CMS CCI IO (Baltimore, MD)Ability to work Eastern Time Zone hours, including flexible scheduling during open enrollment surge periods (October–January)Potential travel for meetings to locat ions throughout Baltimore, MD and/ or Washington, DC area s$145,000 - $205,000 a yearThe offered rate will be based on the selected candidate's knowledge, skills, abilities and/or experience and in consideration of internal parity. The posted range is appropriate for a typical candidate meeting, at a minimum, all the core requirements of the position.Computer World Services is an affirmative action and equal employment opportunity employer. Current employees and/or qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, disability, protected veteran status, genetic information or any other characteristic protected by local, state, or federal laws, rules, or regulations.Computer World Services is committed to the full inclusion of all qualified individuals. As part of this commitment, Computer World Services will ensure that individuals with disabilities (IWD) are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Human Resources at [emailprotected] .We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Job Description

CWS is pursuing the CMS Marketplace Service Desk (MSD)opportunity. The MSD supports the Center for Consumer Information and Insurance Oversight (CCIIO) by providing technicalassistanceto issuers, agents and brokers, Application Development Organizations (ADOs), state agencies, and otherAffordable Care Act (ACA)Marketplace stakeholders.The Marketplace Domain SME is a key position responsible for providing deep subject matterexpertisein the ACA Health Insurance Marketplace, Qualified Health Plan (QHP) certification, and CCIIO program operations. This individual will serve as the resident domain authority forourMSD team — ensuring service desk operations, knowledge management content, training curricula, and stakeholder communications reflectaccurate, current Marketplace policy and regulatory knowledge.Key Tasks & ResponsibilitiesMarketplace Domain Expertise and AdvisoryServe as the MSD team's primary subject matter authority on ACA/ Patient Protection and ACA (PPACA) policy, regulation, and CCIIO program operationsMonitor and interpret annual Notice of Benefit and Payment Parameters (NBPP), plan year guidance, and CCIIO policy updates; brief operations staff on changes affecting MSD scopeProvideexpert guidance on QHP certification cycle requirements, issuer obligations, and CMS-issuer relationship managementSupport Tier 2 and Tier 3 escalation resolution for complex policy, regulatory, and plan management inquiriesKnowledge ManagementLead development and maintenance of the MSD knowledge base, ensuring accuracy and currency of articlesand related materialsAuthor and review Tier 1–3 resolution guides, Standard Operating Procedures (SOP), and escalation playbooks for Marketplace-specific issue categoriesEnsure knowledge base content reflects current plan year policies, system changes, and issuer/agent-broker guidanceCoordinate with AI/automation tools team to ensure triage bots and self-service content accurately reflect current Marketplace guidanceTraining and Staff DevelopmentDesign and deliver Marketplace domain trainingand mentorshipfor MSD Customer Service Representatives and SeniorAnalystsonboarding and annually for plan year refreshersand surge-readiness training materialsStakeholder and Account Management SupportSupport Account Manager in issuer communications, onboarding, and annual QHP certification cycle outreachContribute domainexpertiseto CMS-facing deliverables including monthly reports, escalation summaries, and continuous improvement recommendationsAssistin preparing CMS briefings on Marketplace issue trends, emerging policy questions, and stakeholder feedback patternsEducation & Experience EducationBachelor's degree required in health policy, public administration, public health, business administration, information technology, or a related fieldExperienceMinimum 5 years of direct experience supporting CMS CCIIO Marketplace operations, QHP certification, issuer relations, or ACA plan managementDirect experience on the CMS Marketplace Service Desk (MSD) or a closely adjacent CCIIO programDemonstratedexpertisein QHP certification processes, including HIOS/MPMS submission workflows, plan management requirements, and issuer compliance obligationsExperience developing ormaintainingknowledge management content, SOPs, or training materials in a federal help desk or program support environmentExcellent written and verbal communication skills; experience preparing federal deliverables, briefings, or policy documentsTechnical KnowledgeIn-depth knowledge of HIOS (Health Insurance Oversight System), MPMS (Marketplace Plan Management System), and/or SERFF as used in the QHP certification processFamiliarity with CMS Marketplace Quality Initiatives: Quality Rating System (QRS), QHP Enrollee Survey, and Quality Improvement Strategy (QIS)Working knowledge of ACA/PPACA statute, associated federal regulations, and annual CCIIO guidance documentsUnderstanding of CCIIO stakeholder ecosystemPreferredQualificationsPrior key personnel designation on a CMS or federal health IT service desk contractExperience with ITSM platforms (ServiceNow or equivalent) in a federal service desk environmentExperience with AI-assisted knowledge management tools or chatbot/virtual agent content developmentEstablished relationships within the CCIIO/Marketplace contractor or federal program communityCertificationsPMP, ITIL Foundation, or equivalent project/service management certificationpreferredSecurity ClearanceMust be able to obtain a federal Public Trust , Moderate Background Investigation (MBI ), or higher clearanceOther (Travel, Work Environment, DoD 8570 Requirements, Administrative Notes, etc.)Remote / Telework with occasional work at CMS CCI IO (Baltimore, MD)Ability to work Eastern Time Zone hours, including flexible scheduling during open enrollment surge periods (October–January)Potential travel for meetings to locat ions throughout Baltimore, MD and/ or Washington, DC area s$145,000 - $205,000 a yearThe offered rate will be based on the selected candidate's knowledge, skills, abilities and/or experience and in consideration of internal parity. The posted range is appropriate for a typical candidate meeting, at a minimum, all the core requirements of the position.Computer World Services is an affirmative action and equal employment opportunity employer. Current employees and/or qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, disability, protected veteran status, genetic information or any other characteristic protected by local, state, or federal laws, rules, or regulations.Computer World Services is committed to the full inclusion of all qualified individuals. As part of this commitment, Computer World Services will ensure that individuals with disabilities (IWD) are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Human Resources at [emailprotected] .We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.