UAT Tester SME - Must have Health Insurance Exchange (HIX) operations and SBMFP environment

Oregon Health Authority

100% REMOTE but MUST be local to Oregon

Long term contract

• UAT Tester SME- MUST HAVE TO APPLY-- Experience working in a Health Insurance Exchange (HIX) environment, including experience within Oregon''''s current StateBased Marketplace using the Federal Platform (SBMFP) or experience working in a fully StateBased Marketplace (SBM).
• Advanced understanding of Marketplace operations including eligibility, enrollment workflows, plan management, account transfers, redeterminations, and consumer assistance functions.

The Oregon Health Authority OHIM seeks an experienced UAT Business Subject Matter Expert Tester to support the SB 972 Transition Project as Oregon moves from an SBM FP to a full State Based Marketplace (SBM). Contractor''''s Key Person shall work closely with Marketplace business partners, GetInsured, Medicaid/ONE system teams, and technical teams to ensure the new marketplace platform meets business needs, supports compliance, and delivers accurate, highquality functionality.
Contractor''''s Key person shall provide advanced user acceptance testing support for the development and implementation of Oregon''''s new StateBased Marketplace (SBM). Contractor''''s Key Person shall ensure that eligibility, enrollment, and Marketplace operations systems meet business needs, align with policy, and function correctly for consumers, partners, and programs.
Contractor''''s Key Person shall collaborate closely with Marketplace business partners, product staff, technical teams, the Oregon Health Insurance Marketplace''''s vendor GetInsured, and Oregon''''s Medicaid division—specifically the teams supporting the ONE eligibility system to design, execute, and validate UAT activities in both agile and traditional delivery environments. Contractor''''s Key Person shall serve as a subject matter expert in test design, test execution, defect analysis, and continuous improvement of testing processes.

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Required Skills and Experience:

• 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 nontechnical 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.

In addition, the ideal candidate MUST have skills and experience in:

• Experience working in a Health Insurance Exchange (HIX) environment, including experience within Oregon''''s current StateBased Marketplace using the Federal Platform (SBMFP) or experience working in a fully StateBased 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 MAGIbased 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.