Manage a team of five professionals including Business Analysts, Security & Privacy Lead, and a Report Developer / Reporting Lead who execute critical quality assurance and reporting functions.
Oversee team members who lead daily defect triage meetings, conduct system QA checks, and develop regulatory reporting dashboards.
Manage team capacity, project scope, and resource allocation to ensure all deliverables meet quality standards.
Review and approve team deliverables, timesheets, and work products.
Provide mentorship and professional development for team members.
Manage access permissions for the PMQA and UAT teams.
Oversee access management for the team and manage team capacity planning.
Oversee the team's execution of daily production defect triage and readiness meetings.
Review and approve weekly defect and system-stability reports for leadership.
Deliver as-needed Independent Validation & Verification (IV&V) support for CMS interface testing and approval.
Provide expert assessment of Open Enrollment system readiness, including performance and endurance testing evaluation.
Lead incident response preparations, including facilitation of mock incident events.
Ensure the team conducts thorough application quality assurance through daily checks of key indicators (notice volumes, account transfers, anomalous APTC values, etc.).
Oversee security management support for annual audits and regulatory compliance processes.
Strategic Project Management.
Serve as Project Manager for cross-functional initiatives supporting the SBE's operations.
Spearhead daily Open Enrollment meetings with executive stakeholders, ensuring alignment and swift issue resolution.
Collaborate seamlessly with SBE team members and the core platform vendor.
Champion continuous process improvement through documentation and lessons learned activities.
Project manage regulatory implementations including HR1 and CMS Marketplace Integrity and Affordability rulings.
Provide strategic support for plan management activities in preparation for Open Enrollment.
Oversee the team's support for Auto Renewal:
Review methodology and required reporting.
Ensure comprehensive tracking and test case validation.
Ensure development of business scenarios / outcomes presentations.
Direct the team's support for 1095-A Tax Form:
Ensure development of business scenarios / outcomes presentations.
Oversee quality assurance of production runs.
Validate end-to-end process integrity.
Manage oversight of Periodic Data Matching (PDM) and Federal Tax Reconciliation (FTR) processes:
Ensure proper preparation, testing, and execution.
Validate results meet federal requirements.
Drive quality assurance initiatives for critical deliverables and reports.
Ensure the team prepares and validates daily business dashboards.
Oversee development of regulatory reports and internal management reports.
Validate monthly Carrier Financial Reports for accuracy and completeness.
Ensure operational measures are properly developed and tracked throughout Open Enrollment.
Serve as the engagement lead.
Present complex technical information to executive stakeholders in accessible formats.
Support the drafting of issuer communications and presentations.
Facilitate knowledge transfer between technical and operational teams.
Represent the PMQA team in cross-functional meetings and governance forums.
Manage the SBE's project plan and the PMQA team project plan.
Project manage initiatives driven by regulatory changes (most recently including HR1 bill and CMS Marketplace Integrity and Affordability rulings).
Provide assessment of OE readiness, including performance and endurance testing review.
Support major system and call center incident responses, including participation in mock incident events.
Provide responsive and flexible project management to address emerging issues.
Deep multi-year experience in a State-Based Marketplace environment with strong domain knowledge.
5+ years of project management experience in healthcare technology environments.
3+ years of team management experience leading technical and analytical professionals.
Proven experience managing quality assurance processes for complex systems.
Strong understanding of health insurance exchange operations, including plan management, eligibility, and enrollment processes.
Experience with CMS reporting requirements and IV&V methodologies.
Demonstrated success leading incident response and defect management in mission-critical systems.
Experience with business requirements elaboration and documentation.
Strong technical acumen with ability to translate complex system issues into business impacts.
Excellent executive communication and presentation skills.
Ability to manage multiple high-priority initiatives in a fast-paced regulatory environment.
Experience facilitating cross-functional collaboration between technical and operational teams.
Proficiency with project management tools and methodologies.
Experience with Open Enrollment operations and critical annual processes.
Project Management Professional (PMP) certification.
Experience with GetInsured platform or similar exchange technology.
Background in healthcare policy implementation
Experience with Agile methodologies in a regulated environment.
Understanding of EDI transaction processing for health insurance enrollment.
Applicants must be authorized to work in the United States, without the need for visa sponsorship by North Highland. Work visa sponsorship will not be provided, either now or in the future, for this position.
North Highland is an equal opportunity employer, and we adhere to all applicable laws and regulations to ensure a fair and equitable workplace. All qualified applicants will receive fair and impartial consideration without regard to race, color, sex, gender identity, religion, national origin, age, sexual orientation, disability, veteran status, or any other characteristic protected by law. We handle all information in accordance local privacy standards and maintain strict confidentiality.
North Highland Consulting
Nov 20, 2025