Integration Lead / Project Manager

Integration Lead/Project Manager

Rate : ALAP
Location Atlanta _ GA

Last Date : 5/19/2025

Local candidates only as they will be required to work onsite 3 days per week.

The Partner Integration Lead is a member of the Technology Department and reports to the Partner Integration Manager. The Partner Integration Lead is responsible for analyzing EDE (Enhanced Direct Enrollment) Partners policies, and participate in inspections and program evaluations that integrate with the Georgia Access Eligibility & Enrollment System to provide a seamless consumer health insurance shopping experience from application to enrollment. The Project Manager will build a deep knowledge of all aspects of the functions and will collaborate closely with the Business Technical Analyst to identify and meet emerging needs and improvement opportunities. Staff, including the Project Manager, are expected to develop working knowledge of federal requirements, reports, policies, systems, and regulations as they apply to the responsibilities of their role.

Responsibilities:
This role manages all aspects of the CMS and EDE Partner-related coordination and activities, including the annual partner Operational Readiness Reviews (ORRs), change management, system testing, insurance carrier backend processes, and partner compliance reviews.
The responsibilities of this role include, but are not limited to the following:

Program Operations
Support the annual partner application process including application updates, reviews,and approvals.
Support the technical implementation of the program for partners for Open Enrollment (OE) 2026 go-live on November 1, 2026, and ongoing.
Support the annual partner ORRs with support from the Eligibility and Policy Manager and the Information Security Officer.
Manage the review and approval of partner consumer QHP applications and technical change requests with support from other staff as needed.
Facilitate communication between internal teams, partners, and CMS, acting as the point of contact for project-related inquiries.
Maintain detailed records of the partner application process, ORR status, and CMS change requests.
Generate regular project status reports and provide updates to senior management on progress, challenges, and solutions.
Coordinate reviews and approvals of partner applications, ensuring all necessary documentation and approvals are in place.
Work closely with internal teams to manage communications and feedback during the application process.
Host regular coordination meetings with cross-functional teams (e.g., Legal, Policy, Operations) to ensure alignment and address any concerns during the application cycle.
Monitor CMS changes to their Enhanced Direct Enrollment (EDE) program and SBE requirements and coordinate with the Eligibility and Policy
Manager to determine the impact and what changes will be adopted by Georgia Access.
Direct the required partner documentation updates (e.g., ORR materials, business requirements, technical requirements) and review updates completed by the Partner Integration Analysts.
Monitor changes made by CMS to the Enhanced Direct Enrollment (EDE) program and provide feedback to leadership if the same changes should be adopted by Georgia Access.
Developing project scopes and objectives, involving all relevant stakeholders and ensuring technical feasibility
Creating and maintaining comprehensive project documentation
Developing detailed project plan(s) and visual tools to track progress
Perform risk management to minimize project risks
Reporting and escalating to management as needed
Coordinating mitigation of project issues that arise
Participating in crafting and documenting appropriate responses to major business issues that arise and could significantly impact stakeholders

Stakeholder Engagement
Serve as the main point of contact on behalf of the SBE for Center of Medicaid and Medicaid Services (CMS) and all EDE partners & Issuers
interactions, including program and technical questions, issues, and coordination with technical vendor(s).
Skilled in facilitating meetings, discussions, and brainstorming sessions to drive decisions and outcomes.
Meet regularly with the partners to communicate program and policy updates, technical progress, challenges, and mitigation strategies as necessary.
Meet with the Technology Director, leadership, and partners to communicate technical program status, progress, timelines, challenges, system
issues, and proposed mitigation strategies as needed.
Establishing and maintaining relationships with third parties/vendors and business partners
Managing relationships with internal clients and all stakeholders

Education & Years of Experience
Bachelor s degree and at least 6 years of relevant professional experience.
Master's degree in a relevant field may be substituted for 2 years of experience.

Experience, Knowledge, & Skills
Strong background in managing technology implementation projects.
Proficient in project management software (e.g., Microsoft Project, Jira etc).

Preferred Qualifications
Certification (or working toward certification): PMP, SSCP, CISSP, CISA, CISM.
Experience with CMS integrations and requirements.
Experience with state health insurance Exchanges, the federal Exchange, or EDE partners.
Understanding of the Affordable Care Act (ACA) and the individual market, including federal and state health insurance policies and programs.
Experience working with and/or processing 834 enrollment files.
Experience working in and/or with governmental agencies.

Skill Required / Desired Amount of Experience
Proficient in project management software (e.g., Microsoft Project, Jira etc). Required 6 Years
Proven work experience in managing technology implementation projects. Required 6 Years
Certification (or working toward certification): PMP, SSCP, CISSP, CISA, CISM. Highly desired
Experience with CMS integrations and requirements. Highly desired 3 Years
Experience with state health insurance Exchanges, the federal Exchange, or EDE partners. Highly desired 3 Years
Understanding of the Affordable Care Act (ACA) and the individual market, including federal and state health insurance policies and programs. Highly desired 3 Years
Experience working with and/or processing 834 enrollment files. Highly desired 3 Years
Experience working in and/or with governmental agencies. Highly desired 3 Years