Business Subject Matter Expert

Contractor’s Key Person will support the Transition Project as the marketplace moves from an SBM FP to a full State-Based Marketplace (SBM). This role involves close collaboration with Marketplace business partners, GetInsured, Medicaid/ONE system teams, and technical teams to ensure the new platform meets business needs, supports compliance, and delivers accurate, high-quality functionality.

Responsibilities

• Review and analyze project requirements, user stories, use cases, process flows, and acceptance criteria for clarity, completeness, and testability.
• Maintain and update the requirements traceability matrix (RTM).
• Create, update, and maintain UAT test cases, scenarios, test data, and test suites.
• Contribute to UAT test plans outlining testing scope, approach, environments, schedule, resources, and risks.
• Execute manual UAT test cases and document detailed results, including evidence, discrepancies, and validation outcomes.
• Participate in test case review sessions and identify automation candidates for collaboration with automation engineers.
• Support regression testing and verify defect fixes to ensure system stability.
• Support exploratory testing, targeted bug hunts, and ad-hoc validation activities.
• Log defects with clear reproduction steps, supporting documentation, and expected behavior; retest defects and confirm resolution using JIRA.
• Perform or support integration testing across systems, APIs, services, and interfaces affecting Marketplace operations.
• Contribute to or support load, performance, security, and accessibility testing.
• Prepare, request, or curate test data required for UAT cycles.
• Validate UAT readiness including requirements, environments, tools, and data availability.
• Participate in defect triage, contributing to assessments of priority, severity, and business impact.
• Provide guidance, coaching, and support to business SMEs participating in UAT.
• Develop and maintain UAT best practices, documentation, templates, and training materials.
• Provide daily/weekly test metrics, summaries, and progress updates to program leadership.
• Fully participate in Scrum ceremonies (if applicable) including planning, refinement, stand-ups, demos, and retrospectives.
• Contribute to release readiness assessments and go/no-go recommendations.
• Learn and apply basic automation concepts and collaborate with automation engineers where applicable.
• Identify continuous improvement opportunities for UAT processes, tools, and cross-team collaboration.
• Serve as a Business SME Tester responsible for validating system behavior from an end-to-end business perspective.
• Develop user acceptance test cases and execute testing.
• Ensure that system outputs align with Marketplace policy, operational workflows, and federal and state regulations.

Requirements

• Strong understanding of UAT methodologies, SDLC, and Agile/Scrum frameworks.
• Ability to analyze business and technical requirements and translate them into effective test cases.
• Experience designing and executing complex test scenarios.
• Proficiency using test management and defect tracking tools (Azure DevOps, Jira, etc.).
• Strong analytical and problem-solving skills.
• Excellent communication skills for both technical and non-technical audiences.
• Ability to prioritize work, manage time effectively, and operate with limited supervision.
• Understanding of accessibility standards (WCAG), security testing fundamentals, and performance considerations.
• Ability to identify risks and propose mitigation strategies.
• Strong interpersonal and collaborative skills.

Marketplace Domain Expertise

• Deep understanding of Health Insurance Exchange (HIX) operations, including differences between SBMs and SBMFPs.
• Experience supporting Oregon’s current SBMFP environment and the ability to translate that knowledge to the upcoming SBM model.
• Strong knowledge of ACA Marketplace policy, including eligibility, enrollment, plan management, account transfers, redeterminations, and consumer assistance.
• Advanced understanding of Marketplace interactions with state Medicaid systems, including MAGI rules, account transfers, coordinated eligibility, and data exchange requirements.
• Understanding of Marketplace impacts on carriers, assister programs, enrollment partners, and call center operations.
• Ability to convert Marketplace policy, CMS guidance, and regulatory requirements into system rules, business logic, and UAT test scenarios.

Preferred Qualifications

• Experience working in a Health Insurance Exchange (HIX) environment, including experience within current State-Based Marketplace using the Federal Platform (SBMFP) or experience working in a fully State-Based Marketplace (SBM).
• Advanced understanding of Marketplace operations including eligibility, enrollment workflows, plan management, account transfers, redeterminations, and consumer assistance functions.
• Experience supporting or integrating Marketplace operations with a state Medicaid system, including MAGI-based eligibility, account transfers, and coordinated eligibility processes.
• Advanced understanding of ACA rules and regulations including APTC/CSR eligibility, enrollment rules, special enrollment periods, and federal reporting/compliance requirements.
• Familiarity with test automation frameworks (Selenium, Playwright, Robot Framework, etc.).
• Experience preparing or managing complex test data sets.
• Background or training in business analysis or broader QA disciplines beyond UAT.

Pay

$113-118 per hour

Schedule

Remote