Sr. Program Manager Health Policy and Research

Position Description

Serco is seeking a self-starter Senior Health Policy and Research Manager to join our talented and fast-paced team supporting millions of people applying for healthcare coverage via the Federally Facilitated Marketplace (Marketplace). This dynamic position advises on the potential impact of federal and state health policy on the CMS Eligibility Support (ES) Program, which processes eligibility verification for program coverage and subsidies. The successful candidate will apply extensive knowledge of CMS coverae programs to guide CMS and Service Delivery teams on implementing necessary program changes in response to new policies. The candidate will also lead teams on internal and external audits and special research projects to ensure compliance and drive program improvements. As such, the candidate in this role will closely collaborate with Serco leadership, Service Delivery, IT and Operations teams, and CMS executives.

The candidate in this position ideally brings unique combination of subject matter expertise in federal health program policy and regulations (particularly the Health Insurance Marketplace, Medicare, Medicaid and CHIP), policy research and data analytics, and extensive program implementation/project management experience. Successful candidate will experience managing teams working on diverse projects under competing timeframes.

In this role, you will:

• Proactively apply knowledge and understanding of federal health policies and programs to inform and guide Marketplace verification program and business processes.
  • Monitor health policy guidance, regulations, and legislation (“policy”). Identify and track policy changes that would impact Marketplace eligibility and verification requirements and processes.
  • Inform and guide CMS and Serco teams on changes to health policy and insurance program and best approaches for ES program to reflect new policy changes, maintain compliance, and ensure quality consumer experience.
  • Evaluate policy changes, assess program impacts, develop program options, and provide in-depth analysis and recommendations for process and operational implementation.
• Evaluate ES program policy changes, and improvements/enhancements in process and operations that would impact consumer verification experience or outcomes.
  • Work with Service Delivery and Data Analytics teams to examine program policy or business process changes and assess potential impacts on consumers applying for health insurance through the Marketplace.
  • Proactively propose analytical studies of improve Marketplace program application, eligibility and verification process.
  • Develop strategic planning and program improvements initiatives that would optimize Marketplace eligibility processing and enhance consumer enrollment outcomes.
• Manage cross-cutting projects and research studies
  • Keep ES teams informed on latest relevant health policy analysis, research, evaluations, and reports from government, industry, think tanks, and advocacy organizations
  • Manage and/or coordinate priority projects that crosscut multiple teams and product lines to analyze business, functional, and technical requirements.
  • Propose and execute CMS ad hoc studies and projects, including developing contract proposal with CMS; managing subcontracting process; project management, coordination and oversight.
• Deliver executive level communication and consultation to CMS and Serco.
  • Collaboratively work with CMS and Serco teams to produce high-level, well-written memos, briefs, analysis, evaluations, reports and presentations.
  • Effectively communicate impact of key policies and business processes by developing and delivering strategically framed oral and written briefings with clear and concise descriptions of policy and/or program changes including options, requirements, potential impact.
  • Develop and maintain effective and efficient working relationships that build confidence and trust with the government leadership and SMEs, and Serco teams.
• Perform other tasks as required or assigned.

Qualifications

To be successful in this role, you must have:

• Graduate degree in law, public health, public policy, political science, government, health administration or other appropriate degree required.
• Minimum five years of experience performing complex legislative, regulatory and program analyses and/or conducting and managing qualitative and quantitative research on government health programs (such as Marketplace, Medicare, Medicaid).
• Minimum 3 years management experience.

Desired Qualifications:

• Understanding of ACA and Marketplace policy issues affecting consumer coverage