Project Manager PMP

Under broad supervision, manages projects through full life cycle from project definition through implementation of project deliverables. Creates collaborative partnership with all internal and external team members to accomplish the deliverables.

The State of Georgia is implementing a State-based Exchange (SBE), Georgia Access, to improve access to affordable, quality health insurance for residents. The Go-live date for the SBE was November 1, 2024. The SBE is being implemented as a new division within the Office of Commissioner of Insurance and Safety Fire (OCI). The goals of Georgia Access are to increase competition, innovation, and private sector investment in Georgia s market, improve the shopping and enrollment experience for consumers, and reduce the number of uninsured Georgians. Georgia Access is designed to enhance consumer choice by facilitating a more competitive marketplace with Georgia s private-sector partners providing innovative solutions for enrollment. Consumers will have the option to shop for, compare, and enroll in qualified health plans (QHPs) and stand-alone dental plans (SADPs) through certified web-brokers and health insurance carriers in addition to the State s consumer portal. Georgia Access will be the nation s first SBE that offers both private - and public-sector enrolment channels for consumers. The State will also certify Navigators and Certified Application Counselors (CACs) to provide consumer assistance. Georgia Access is comprised of a number of technology providers, partners, and interfaces. In the current plan, a contracted vendor will implement and maintain the Georgia Access Eligibility and Enrollment System as a Software-as-a-Service (SaaS) product. The Eligibility and Enrollment System will have several interfaces with federal and state systems, including the Federal Data Services Hub, the Centers for Medicare & Medicaid Services (CMS), Internal Revenue Service (IRS), and the State s Medicaid eligibility system. In addition, the Eligibility and Enrollment System interfaces with health insurance carriers for consumer enrollment information and with private sector partners (e.g., web-brokers) for plan shopping and selection. Georgia Access must maintain

compliance with HIPAA, PHI, and PII across all vendors and systems.

The Partner Integration Lead is a member of the SBE s Technology Department and reports to the Partner Integration Manager. The Partner Integration Lead is responsible for analyzing SBE s 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 SBE functions and will collaborate closely with the Bus iness Technical Analyst to identify and meet emerging needs and improvement opportunities. SBE staff, including the Project Manager, are expected to develop working knowledge of federal SBE requirements, reports, policies, systems, and regulations as they apply to the responsibilities of their role. Local candidates only as they will be required to work onsite 3 days per week.

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:

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 SBE 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

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, SBE 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

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).

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.