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The Marketplace Domain SME is responsible for providing deep subject matter expertise in the ACA Health Insurance Marketplace, Qualified Health Plan (QHP) certification, and CCIIO program operations. This role will serve as the resident domain authority for the MSD team, ensuring service desk operations, knowledge management content, training curricula, and stakeholder communications reflect accurate, current Marketplace policy and regulatory knowledge. Key responsibilities include providing expert guidance, monitoring and interpreting policy updates, supporting escalations, leading knowledge base development, authoring SOPs, and designing training.
CWS is pursuing the CMS Marketplace Service Desk (MSD) opportunity. The MSD supports the Center for Consumer Information and Insurance Oversight (CCIIO) by providing technical assistance to issuers, agents and brokers, Application Development Organizations (ADOs), state agencies, and other Affordable Care Act (ACA) Marketplace stakeholders.
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.
CWS is pursuing the CMS Marketplace Service Desk (MSD) opportunity. The MSD supports the Center for Consumer Information and Insurance Oversight (CCIIO) by providing technical assistance to issuers, agents and brokers, Application Development Organizations (ADOs), state agencies, and other Affordable Care Act (ACA) Marketplace stakeholders.
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.
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
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
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
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 hr@cwsc.com.