Program Specialist
Washington, Dc, Us
Developed Multi-State Plan (MSP) Program certification standards and operational review requirements for MSP issuer applicants and NHO reviewers. Served as Lead Benefit Reviewer to manage NHO MSP issuers’ proposals for quality and compliance.KEY COMPETENCIES: SUBJECT MATTER EXPERTISE, PROJECT MANAGEMENT, TRAINING, POLICY ANALYSIS, COLLABORATIONEnsured high performance of insurance offerings emerging into new marketplaces● Collaborated with Centers for Medicare and Medicaid Services to develop issuer quality standards and guidelines, quality rating system, health plan enrollee survey, and quality improvement strategy● Obtained bi-agency regulatory approval ● Published and distributed standards and guidelines with supported training to applicant issuersKEY COMPETENCIES: PROJECT MANAGEMENT, AGILE SCRUM, BUDGET MANAGEMENT, USER TRAINING, TEAM BUILDING, TESTINGSupported MSP issuer application and contract negotiation/oversight through launch of first continuous integration/ development Agile framework worth $3M● Established Agile Scrum teams and exercised daily Sprint and Kanban ceremonies● Developed, implemented, and tested product requirements for user base of 1000+● Shipped applications into production environment on time and conducted user training to ensure uptakeKEY COMPETENCIES: SUBJECT MATTER EXPERTISE, COMPLIANCE, POLICY ANALYSIS, COLLABORATIONAchieved compliance for essential health benefits and formularies on individual exchange marketplaces as Lead Benefit Reviewer● Reviewed applicant MSP issuers’ medical and prescription drug proposals● Collaborated with state insurance departments and federal partnerships to evaluate issuer compliance ● Escalated approved MSP issuers to certification-ready status, available for public exchange offering