Marketplace Enrollment and Appeals Specialist (PA2) Limited Duration

Marketplace Enrollment and Appeals Specialist (PA2) Limited DurationThe Marketplace Enrollment and Appeals Specialist serves as a Medicaid and Marketplace insurance subject matter expert, analyzing complex eligibility, enrollment, technology platform, escalation, complaint, and appeal issues. The role evaluates program operations for the state-run platform and Consumer Assistance Center (CAC), supports CAC contract leads, develops operational guidance, and assists with training, compliance, and quality assurance. If this opportunity aligns with your strengths, background, and commitment to fostering inclusivity, we encourage you to apply! At the Oregon Health Authority (OHA), we value diversity and encourage applicants from all backgrounds and experiences to help us build a stronger, more equitable future for all. Opportunity Awaits, Apply Today! Marketplace Enrollment and Appeals Specialist (PA2) Limited Duration through June 30th, 2027 What We Are Looking For Minimum Qualifications: These qualifications must be visible in your application for consideration. A Bachelor's Degree in Business or Public Administration, Behavioral or Social Sciences, or a degree related to the agency program that demonstrates the capacity for the knowledge and skills; and two years experience coordinating or administering a program OR Any combination of experience or education equivalent to five years of experience that typically supports the knowledge and skill requirements listed for the classification. A valid license and satisfactory driving record, as travel and use of state vehicles are active functions of the position. Desired Attributes: The following are desired attributes that we have identified as key to success for this role at OHA. These are the attributes we are looking for in our top candidate. If you have any of these, please let us know in your application. Extensive knowledge of Medicaid and Marketplace insurance programs, including eligibility, enrollment, appeals, identity verification, consumer assistance operations, and related state and federal programs such as Division of Financial Regulation programs and Medicare. Demonstrated expertise in analyzing complex case scenarios, identifying issues, evaluating options, and implementing effective solutions within a state-run technology platform and Consumer Assistance Center environment. Proven experience in healthcare customer service, assessing consumer needs, meeting quality standards, and evaluating customer satisfaction in high-volume or high-stress settings. Highly skilled in problem solving, critical thinking, and communicating effectively with individuals from diverse educational and cultural backgrounds. Exceptional ability in exercising tact and diplomacy to gain cooperation while demonstrating firmness, impartiality, and sound judgment in controversial or strained circumstances. Demonstrated ability in data collection, analysis, and evaluation to support operational and program decision-making, including use of automated data systems, spreadsheets, word processing, and tracking databases. Proven capability in written and verbal communication tailored to Marketplace consumers, partners, and community and program partners, including actively listening and conveying complex information clearly. Collaboration skills to work effectively with state agencies, carriers, contractors, and community partners to resolve issues and improve service delivery. Application Guidance Your candidate profile and application are your opportunity to showcase your skills and interest in this role. Submissions will be reviewed for clarity, consistency, and communication skills, and for alignment with the guidance provided in the below: Submission Requirements: Resume Attach your current resume that clearly outlines your education and work experience relevant to this position. Cover Letter A cover letter is required and will be reviewed and considered during the review and selection process. Supplemental Questions Answer all supplemental questions completely and accurately. Final Check! Before submitting, confirm that all required materials are included, and your Workday Job History is current. The information in your application will be used to complete an Equal Pay Analysis to determine salary placement upon hire. Visit the Equal Pay Analysis Webpage for more information. How to Apply: External Candidates: Visit the State of Oregon job opportunities webpage or click the "Apply" tab above to submit your application, following all submission requirements. Internal Candidates: Current State of Oregon employees must apply through their Workday login, following all submission requirements. After You Apply: Complete any pending tasks in Workday under "My Applications" prior to the application deadline. Check your email (including junk folder) and Workday inbox regularly for updates on your application. Reminders: Eligible veterans and Oregon National Guard servicemembers (current and former) who meet the qualifications of the position will be awarded candidate preference. To protect your information and ensure correct processing, please follow the instructions for submitting your Veterans' Preference documentation. Please download and save a copy of this job announcement and linked position description, as it is not available after the application deadline. About the Team & Benefits of Joining We offer a workplace that balances productivity with enjoyment; promote an atmosphere of mutual respect, dedication, and enthusiasm. You will collaborate with a team of bright individuals to work with and learn from. If you're driven by the passion to do something meaningful that changes lives, the Oregon Health Authority is the place for you. We also offer a competitive benefits package including: Excellent, low-cost medical, vision, and dental coverage for you and your family. Optional benefits like life insurance, disability coverage, deferred compensation, and FSA options for health and childcare. Generous paid time off: 11 holidays, 3 personal days, monthly sick leave, and vacation accrual starting at 8 hours/month. Potential eligibility for the Public Service Loan Forgiveness Program. Retirement security through Public Employees Retirement System (PERS)/Oregon Public Service Retirement Plan (OPSRP). Training and development opportunities to grow your career with the State of Oregon. Additional Details This announcement is for a full time Limited Duration SEIU represented PA2 position. This position can be based in Salem, or Portland Oregon, or hybrid. This is a hybrid/remote position. "Review Section 4: Working Conditions" in the position description (linked above) for more information. Employment is contingent upon a criminal records check and a driving records check that meets OHA criteria at the time of hire and throughout employment. The salary listed is the non-PERS qualifying range. If the successful candidate qualifies for PERS, the salary range will increase by 6.95%. For more information, see the Classification and Compensation page. The State of Oregon does not request or require your age, date of birth, attendance or graduation dates from an education institution during the application process. This position does not provide visa sponsorship. Within three days of hire, you will be required to complete I-9 documentation and confirm authorization to work in the United States. OHA will use E-Verify to verify work authorization. If your employment eligibility depends on sponsorship now or in the future, you will not meet the requirements for this position. We evaluate candidates based on their own skills and experience. Unless explicitly approved, outside resources including Artificial Intelligence (AI) tools are not permitted during assessments or interviews. Use of unauthorized resources will disqualify a candidate from further consideration. Contact Information Recruiter: Tracy Blach Email: tracy.blach@oha.oregon.gov Phone (text friendly): 503-509-5513 Accommodation Requests (ADA): OHA provides reasonable accommodation under the ADA, which may include alternative formats of materials or language support. If you need an accommodation to apply for this position or participate in the selection process, please contact the recruiter listed above. Helpful Links & Resources How to Set Job Alerts | Workday Applicant FAQ | Oregon Health Authority | Facebook | Instagram | LinkedIn | Veterans Resources | What You Need to Know to Get the Job The Oregon Health Authority is an affirmative action and equal opportunity employer, committed to fair employment practices and pay equity for all employees. We do not discriminate based on protected class including race, sex, veteran status, disability, age, color, religion, national origin, marital status, or sexual orientation and does not screen applicants based on current or past compensation. Salary is determined through a fair review of your education, experience, and training as it relates to the position. OHA is an anti-racist organization working to eliminate health inequities and dismantle structural barriers that impact underserved communities. Join us in advancing our Strategic Plan and building a more equitable Oregon.