Computer World Services Corp. (CWS)

Marketplace Domain Subject Matter Expert (SME)

Computer World Services Corp. (CWS) • $145K — $205K *
Baltimore, MD 21215In-Person
Healthcare
5 - 7 years of experience
1 month ago
Job Overview by Ladders

Qualifications

  • Bachelor's degree in health policy, public administration, public health, business administration, or IT-related field
  • Minimum 5 years experience in CMS CCIIO Marketplace operations or ACA plan management
  • Experience on the CMS Marketplace Service Desk or related CCIIO program
  • Expertise in QHP certification processes and compliance obligations
  • Strong communication skills with experience in federal deliverables preparation

Responsibilities

  • Serve as the primary subject matter authority on ACA and CCIIO program operations
  • Monitor, interpret, and brief staff on policy updates affecting MSD
  • Provide guidance on QHP certification and issuer relations management
  • Support complex policy inquiries and resolution for escalated issues
  • Develop and maintain a comprehensive MSD knowledge base
  • Create and review training and SOP materials for Marketplace operations
  • Assist in CMS briefings on Marketplace trends and policy questions

Benefits

  • Remote work flexibility with occasional on-site requirements
  • Ability to work Eastern Time Zone hours
  • Occasional travel for meetings in Baltimore, MD, or Washington, DC
  • Access to ongoing training and development opportunities
Full Job Description
The Marketplace Domain SME is a key position responsible for providing deep subject matter expertise in the ACA Health Insurance Marketplace, Qualified Health Plan (QHP) certification, and CCIIO program operations. This individual will serve as the resident domain authority for our MSD team - ensuring service desk operations, knowledge management content, training curricula, and stakeholder communications reflect accurate, current Marketplace policy and regulatory knowledge.

Key Tasks & Responsibilities

Marketplace Domain Expertise and Advisory

  • Serve as the MSD team's primary subject matter authority on ACA/ Patient Protection and ACA (PPACA) policy, regulation, and CCIIO program operations
    • >


  • Monitor and interpret annual Notice of Benefit and Payment Parameters (NBPP), plan year guidance, and CCIIO policy updates; brief operations staff on changes affecting MSD scope
    • >


  • Provide expert guidance on QHP certification cycle requirements, issuer obligations, and CMS-issuer relationship management
    • >


  • Support Tier 2 and Tier 3 escalation resolution for complex policy, regulatory, and plan management inquiries
    • >


Knowledge Management

  • Lead development and maintenance of the MSD knowledge base, ensuring accuracy and currency of articles and related materials
    • >


  • Author and review Tier 1-3 resolution guides, Standard Operating Procedures (SOP), and escalation playbooks for Marketplace-specific issue categories
    • >


  • Ensure knowledge base content reflects current plan year policies, system changes, and issuer/agent-broker guidance
    • >


  • Coordinate with AI/automation tools team to ensure triage bots and self-service content accurately reflect current Marketplace guidance
    • >


Training and Staff Development

  • Design and deliver Marketplace domain training and mentorship for MSD Customer Service Representatives and Senior Analysts onboarding and annually for plan year refreshers and surge-readiness training materials
    • >


Stakeholder and Account Management Support

  • Support Account Manager in issuer communications, onboarding, and annual QHP certification cycle outreach
    • >


  • Contribute domain expertise to CMS-facing deliverables including monthly reports, escalation summaries, and continuous improvement recommendations
    • >


  • Assist in preparing CMS briefings on Marketplace issue trends, emerging policy questions, and stakeholder feedback patterns
    • >


Education & Experience

Education
  • Bachelor's degree required in health policy, public administration, public health, business administration, information technology, or a related field


Experience

  • Minimum 5 years of direct experience supporting CMS CCIIO Marketplace operations, QHP certification, issuer relations, or ACA plan management
    • >


  • Direct experience on the CMS Marketplace Service Desk (MSD) or a closely adjacent CCIIO program
    • >


  • Demonstrated expertise in QHP certification processes, including HIOS/MPMS submission workflows, plan management requirements, and issuer compliance obligations
    • >


  • Experience developing or maintaining knowledge management content, SOPs, or training materials in a federal help desk or program support environment
    • >


  • Excellent written and verbal communication skills; experience preparing federal deliverables, briefings, or policy documents
    • >


Technical Knowledge

  • In-depth knowledge of HIOS (Health Insurance Oversight System), MPMS (Marketplace Plan Management System), and/or SERFF as used in the QHP certification process
    • >


  • Familiarity 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 documents
    • >


  • Understanding of CCIIO stakeholder ecosystem
    • >


Preferred Qualifications

  • Prior key personnel designation on a CMS or federal health IT service desk contract
    • >


  • Experience with ITSM platforms (ServiceNow or equivalent) in a federal service desk environment
    • >


  • Experience with AI-assisted knowledge management tools or chatbot/virtual agent content development
    • >


  • Established relationships within the CCIIO/Marketplace contractor or federal program community
    • >


Certifications

  • PMP, ITIL Foundation, or equivalent project/service management certification preferred


Security Clearance

  • Must be able to obtain a federal Public Trust, Moderate Background Investigation (MBI), or higher clearance


Other (Travel, Work Environment, DoD 8570 Requirements, Administrative Notes, etc.)

  • Remote / Telework with occasional work at CMS CCIIO (Baltimore, MD)
    • >


  • Ability to work Eastern Time Zone hours, including flexible scheduling during open enrollment surge periods (October-January)
    • >


  • Potential travel for meetings to locations throughout Baltimore, MD and/or Washington, DC areas
    • >


$145,000 - $205,000 a year

The 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.

About Computer World Services Corp. (CWS)

**Computer World Services Corp. (CWS) Careers**

Join the dynamic team at Computer World Services Corp. (CWS), a leader in providing innovative IT solutions and services. At CWS, job opportunities abound for professionals eager to advance their careers in technology and consulting.

Work You’ll Do

At Computer World Services Corp. (CWS), professionals will find themselves at the forefront of digital transformation, helping to shape the future of technology across various industries. The company offers a unique position in the marketplace, combining industry expertise, leadership in innovation, and a commitment to digital advancement.

Explore Career Opportunities

Computer World Services Corp. (CWS) is actively hiring and offers a range of positions from entry-level to senior leadership roles. Explore job opportunities that match your skills and interests in an environment that fosters professional growth and development.

Innovative Work Environment

Engage in groundbreaking projects that push the boundaries of technology and consulting. Computer World Services Corp. (CWS) is dedicated to innovation and excellence, providing employees with the opportunity to work on challenging assignments that drive significant impact.

Join a Diverse and Inclusive Team

Computer World Services Corp. (CWS) believes in the power of diversity and inclusion. The company fosters a culture where differences are embraced, and everyone is given the platform to thrive. Join a team where diversity training and leadership are part of everyday growth and development.

Internship Programs and Employment Benefits

Start your career with Computer World Services Corp. (CWS) through robust internship programs designed to give you a competitive edge. Full-time positions offer substantial benefits, including professional development programs, networking opportunities, and a supportive work environment that champions career advancement and personal growth.

Future-Proof Your Career

With Computer World Services Corp. (CWS), advance your career to new heights with access to unmatched training, certification support, and leadership development programs. The company is committed to the professional growth of its team members, ensuring that each individual's career journey is both rewarding and fulfilling.

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Learn more about Computer World Services Corp. (CWS)
Size
251 employees
Industry
Information Technology
* Ladders Estimates

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