Careers

About the Massachusetts Health Connector

The Commonwealth Health Insurance Connector Authority (Health Connector) is an independent public authority serving as the Affordable Care Act (ACA)-compliant marketplace for the Commonwealth.  The organization is charged with providing subsidized and unsubsidized health insurance to individuals and small employers.  The Health Connector also oversees policy development related to health care reform under both state and federal laws, as well as conducting public education and outreach about health care reform and coverage opportunities.

The Health Connector is an equal opportunity employer that values diversity as a vital characteristic of its work force.  We consider qualified applicants without regard to race, color, religion, gender, sexual identity, gender identity, national origin, or disability.

Eligibility and Enrollment Operations Analyst

Position Summary:

Reporting to the Enrollment Manager, the Eligibility and Enrollment Operations Analyst will serve as a Subject Matter Expert (SME) in Eligibility and Enrollment rules implementation, business validation and production oversight, working with internal teams and external partners and stakeholders to communicate impacts and determine next steps to resolve defects and implement changes as needed.  This position requires the ability to work collaboratively and cross-functionally with IT partners and vendors to drive business objectives and fulfill responsibilities.

Responsible to:

  • Understand CCA eligibility policies and how these should be executed in operations and reflected in system functions to achieve intended results.
  • Document, manage, and monitor changes in functionality needed based on program changes driven by policy and/or changes to laws and regulations.
  • Monitor production process outputs and raise production support issues using established issue tracking systems and software.
  • Communicate urgent issues or significant impacts to internal stakeholders.
  • Coordinate with vendors’ operations, testing and production support teams to suggest fixes to complex issues by doing a thorough analysis of root cause and impact of the defect which may include soliciting feedback from internal stakeholders and leading cross-functional working sessions to ensure understanding of the issue and resolution.
  • Ensure proper prioritization of defects and escalated tickets for Health Connector’s critical business functions.
  • Participate in Joint Application Design (JAD) sessions as an Eligibility and Enrollment SME.
  • Create business validations plans, document test cases, expected and actual results, and coordinate planning and execution of business validations with internal teams, IT partners and vendors.
  • Participate in day to day operational activities including attending ongoing operations and status meetings, participating in working sessions, release planning meetings, defect prioritization meetings, issue trouble shooting sessions and service recovery activities.
  • Provide program support as an Eligibility and Enrollment SME in areas such as member/stakeholder communications, business process design, business operations, policies & procedures.
  • Ensure end-to end business processes are documented and updated on a regular basis to reflect current state.
  • Create, distribute and manage meeting materials and project artifacts such as project plans, power point presentations, operating procedure documentation, risk and decision registers etc.
  • Work collaboratively with the Health Connector internal teams (business, policy, legal and IT) and vendors to coordinate eligibility and enrollment activities, business validations, and other operational and project activities.
  • Interact with key stakeholders including advocates, other state agencies, health plans and vendors to exchange information and/or address specific issues related to the associate’s responsibilities.
  • Monitor relevant reports to track process performance and quality.
  • Perform other responsibilities and participate in projects based on ongoing business needs and as assigned by management.

Experience and Qualifications:

  • A Bachelor’s degree is required
  • Experience in health care, insurance, and/or government operations preferred
  • Vendor Management experience strongly preferred
  • Understanding of Health Insurance industry, the ACA and eligibility rules
  • Understanding of SDLC and testing methodologies
  • Proven analytical and problem-solving skills
  • MS Excel and PowerPoint skills and experience analyzing large datasets using MS Excel
  • Strong organizational, oral and written communication skills
  • Comfort in a fast-paced environment with competing priorities
  • Demonstrated ability to work collaboratively and effectively in a cross-functional environment
  • Self-starter who can work independently

Salary: Salary range is competitive; salary will be commensurate with experience.

Work Setting: This position requires the employee to work on-site in an open office setting.

Please note: Currently all staff are working from home due to COVID-19 precautions, but will return to the office setting when safe.

If Interested: Send cover letter and resume to Connector-jobs@state.ma.us. 

Please note: Due to the requirement of 268A, please complete the disclosure form and return with your application.

About the Health Connector:

The Commonwealth Health Insurance Connector Authority (Health Connector) is an independent public authority serving as the Affordable Care Act (ACA)-compliant marketplace for the Commonwealth. The organization is charged with providing subsidized and unsubsidized health insurance to individuals and small employers. The Health Connector also oversees policy development related to health care reform under both state and federal laws, as well as conducting public education and outreach about health care reform and coverage opportunities.

The Health Connector is an equal opportunity employer that values diversity as a vital characteristic of its workforce. We consider qualified applicants without regard to race, color, religion, gender, sexual identity, national origin or disability.

Contact Center Performance Coordinator

The Contact Center Performance Coordinator, under the direction of the Contact Center Performance Manager, provides day-to-day monitoring of key contact center performance metrics. Contact Center consists of call center, back office and Customer Interaction Centers (CIC). Metrics are used to inform training needs, trends, and ensure agents are providing best possible service to Health Connector members. This position requires close and collaborative work with the vendor responsible for contact center delivery. This is a key role in the delivery of exceptional service to Health Connector members.

Responsibilities include:

  • Monitoring all contact center performance metrics and staffing levels.
  • Provide support and coordination on various projects and activities related to contact center performance, including Open Enrollment ramp-up and performance improvement efforts.
  • Under the direction of the manager, develop and prepare data analysis of contact center performance to be used in various forums to inform Senior Leadership of vendor’s performance.
  • Monitor contact center service level agreements (SLAs)/key performance indications (KPIs) and recommend appropriate incentives or penalties per contractual agreements with vendor.
  • In concert with the contact center team, monitor Customer Satisfaction results, collaborate with vendors on action plan to address negative responses and identify alternative methods to collect and respond to member feedback
  • Support development and/or review of training and communication materials for the contact center.
  • Research and report unique and urgent member issues in a timely and professional manner to contact center vendor.
  • Participate in Quality Assurance Activities such as call monitoring, case reviews, and call calibration sessions to assess whether or not the contact center vendor is meeting the needs of the Health Connector and its customers
  • Assist with other contact center and service recovery activities as needed and assigned.

Qualifications:

  • The ideal candidate will have a working knowledge of state and national healthcare reform and health insurance.
  • BA or BS required.
  • Master’s Degree and familiarity with the healthcare industry, public or private, is preferred.

Other desired skills include:

  • Excellent analytical skills, excellent communication skills, both written and verbal, as well as outstanding interpersonal skills and the ability to work with multiple parties and vendors to implement projects
  • Ability to work independently and on a team
  • Commitment to the goals of the Connector and Health Care Reform; ability to support a wide range of constituents in a constructive and informed manner

Salary: Salary range is competitive; salary will be commensurate with experience.

Work Setting: This position requires the employee to work on-site in an open office setting.

Please note: Currently all staff are working from home due to COVID-19 precautions, but will return to the office setting when safe.

If Interested: Send cover letter and resume to Connector-jobs@state.ma.us. 

Please note: Due to the requirement of 268A, please complete the disclosure form and return with your application.

About the Health Connector:

The Commonwealth Health Insurance Connector Authority (Health Connector) is an independent public authority serving as the Affordable Care Act (ACA)-compliant marketplace for the Commonwealth. The organization is charged with providing subsidized and unsubsidized health insurance to individuals and small employers. The Health Connector also oversees policy development related to health care reform under both state and federal laws, as well as conducting public education and outreach about health care reform and coverage opportunities.

The Health Connector is an equal opportunity employer that values diversity as a vital characteristic of its workforce. We consider qualified applicants without regard to race, color, religion, gender, sexual identity, national origin or disability.

Health Plans and Operations Manager

The Health Plans and Operations Manager serves as the main day-to-day operational liaison between carrier partners and the Health Connector. The manager maintains and enhances the Health Connector interactions with carrier and vendor partners as related to operational processes. The position reports to the Associate Director of Health and Dental Plan Operations.

Key Responsibilities include:

  • Act as a liaison with health and dental carriers, maintaining positive and productive working relationships between the Health Connector and contracted health and dental plans. Represent carriers’ operational interests in internal activities, meetings, and communications. Oversee research and resolution of health and dental plan issues, including gathering required data, coordinating vendor and internal Connector resources, ensuring the timely and accurate analysis of issues, identifying steps for issue resolution, and complete the appropriate communications to carriers and internal partners
  • Work with carrier partners, vendor partners, and internal stakeholders to assess and implement system changes that impact carriers, ensuring carriers are made aware of system changes timely and provided accurate and detailed information on projects or system changes
  • Coordinate external service meetings between Health Connector and health and dental carriers, external business vendors, and lead internal cross departmental meetings including setting agendas, chairing those meetings and ensuring that all active issues are addressed expeditiously
  • Support finance team and vendors in health and dental plan reconciliations to ensure timely, accurate and complete determinations. Monitor and establish metrics to evaluate vendor performance with input from internal and external stakeholders. Work with internal stakeholders to ensure proper data is reporting as requested from carriers or other stakeholders.
  • Support the day to day operations for Qualified Dental Plan operations including, but not limited to:
    • Review escalated cases and manage communication as required by coordinating carrier(s), vendor(s) and internal Connector resources, to ensure cases are resolved expediently within established guidelines
    • Serve as a subject matter expert for dental operations and work with the Associate Director of Health and Dental Plan Operations to monitor agreed upon dental metrics to ensure operational standards and turnaround times are consistently met; and represent dental operations for any modification and improvement initiatives
    • Coordinate annual dental renewal processes, monitoring agreed upon dental metrics to ensure operational standards and turnaround times are consistently met

Additional Responsibilities:

  • Work with the Associate Director of Health and Dental Plan Operations to modify and improve health and/or dental plan facing policies and/or procedures
  • Monitor health and dental plan compliance with Health Connector policies and procedures, identify areas requiring improvement and lead efforts to ensure compliance
  • Prepare and deliver presentations and memoranda to internal and external parties
  • Participate in cross-functional internal collaborations and projects
  • Other projects and duties as assigned by Associate Director of Health and Dental Plan Operations

Experience and Qualifications:

  • Bachelor’s Degree is required
  • Experience with Massachusetts Health and Dental carriers and knowledge of those carriers’ health insurance products
  • Health care experience and background including knowledge of both the public and private sectors
  • Strong operations and project management background, with the ability to work on complex projects and meet deliverables within tight timeframes
  • Excellent communication skills, both written and verbal, as well as outstanding interpersonal skills and the ability to work with multiple parties and vendors to implement projects.

Preferred requirements:

  • Master’s Degree in Health care, business, public health or policy strongly preferred
  • Prior experience working at a health or dental plan
  • Bilingual skills

The ideal candidate must be able to work successfully in a fast-paced environment, have proven ability to successfully multi-task, possess outstanding verbal and written communication skills, strong organizational, project management, analytical, and leadership skills, be able to successfully work independently or on a team, consistently exercise sound judgement, and demonstrate the ability to discern when an issue or situation should be escalated to management.

Salary: Salary range is competitive; salary will be commensurate with experience.

Work Setting: This position requires the employee to work on-site in an open office setting.

Please note: Currently all staff are working from home due to COVID-19 precaution but will return to the office setting when safe.

If Interested: Send cover letter and resume to Connector-jobs@state.ma.us. 

Please note: Due to the requirement of 268A, please complete the disclosure form and return with your application.

About the Health Connector:

The Commonwealth Health Insurance Connector Authority (Health Connector) is an independent public authority serving as the Affordable Care Act (ACA)-compliant marketplace for the Commonwealth. The organization is charged with providing subsidized and unsubsidized health insurance to individuals and small employers. The Health Connector also oversees policy development related to health care reform under both state and federal laws, as well as conducting public education and outreach about health care reform and coverage opportunities.

The Health Connector is an equal opportunity employer that values diversity as a vital characteristic of its workforce. We consider qualified applicants without regard to race, color, religion, gender, sexual identity, national origin or disability.

Testing Analyst

The Testing Analyst will act as a liaison between the Health Connector operations, policy and technology partners to help test and implement technology solutions that meet business needs. This position includes developing and executing test cases and participating in Joint Application Design (JAD) sessions. Areas covered include product development, back office operations, readiness for annual open enrollment and ongoing operational/IT processes.

Key Responsibilities:

  • Develop and execute test cases, document results and coordinate user acceptance test activities with subject matter experts.
  • Actively manage application defects from inception through resolution, working with business SMEs, application designers, developers and testers to effectively prioritize and drive to resolution.
  • Develop and maintain functional and non-functional requirements and Software Development Lifecycle (SDLC) documentation including Use Cases, project plans, test cases, and business process models.
  • Manual execution of User Acceptance Testing (UAT) cases, capturing and reporting results to Health Connector and external vendor project managers.
  • Participate in defect meetings by providing information required to triage and resolve issues encountered during testing.
  • Participate in project meetings such as Joint Application Design (JAD) sessions, defect triage and test case and/or requirements documentation reviews involving cross-functional teams, key business stakeholders and development managers.
  • Collaborate with internal Health Connector and external vendor project managers and initiative leads
  • Work with small teams of senior business analysts, implementation managers, external vendors and consultants to support HIX/IES implementation activities.
  • Participate in larger teams as a team member, and/or work independently.

Qualifications:

  • Bachelor’s Degree in a related field
  • 1-3 years of project experience, including user acceptance testing, business or technical analysis
  • Experience using HP ALM & JIRA tools (preferred)
  • Automation development and execution experience is a plus
  • Understanding of project lifecycle and SDLC
  • Knowledge and interest in technology, public sector and health insurance markets; specifically, PPACA and state-based health insurance marketplace technology and operations
  • Ability to play a support role within a team and to work independently
  • Outstanding communication, interpersonal and relationship building skills
  • Comfort and ability to thrive in an ambiguous, shifting, and fast paced work environment
  • Exceptional analytical skills, ability to learn quickly

Salary: Salary range is competitive; salary will be commensurate with experience.

Work Setting: This position requires the employee to work on-site in an open office setting.

Please note: Currently all staff are working from home due to COVID-19 precaution but will return to the office setting when safe.

If Interested: Send cover letter and resume to Connector-jobs@state.ma.us. 

Please note: Due to the requirement of 268A, please complete the disclosure form and return with your application.

About the Health Connector:

The Commonwealth Health Insurance Connector Authority (Health Connector) is an independent public authority serving as the Affordable Care Act (ACA)-compliant marketplace for the Commonwealth. The organization is charged with providing subsidized and unsubsidized health insurance to individuals and small employers. The Health Connector also oversees policy development related to health care reform under both state and federal laws, as well as conducting public education and outreach about health care reform and coverage opportunities.

The Health Connector is an equal opportunity employer that values diversity as a vital characteristic of its workforce. We consider qualified applicants without regard to race, color, religion, gender, sexual identity, national origin or disability.

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