Marketplace Quality Assurance Officer

Position Overview

Get Covered Illinois is seeking a creative, analytical thinker with experience analyzing technology systems and business operations to serve as our Marketplace Quality Assurance Officer. The Marketplace Quality Assurance Officer will design and implement the Quality Assurance Program for Get Covered Illinois and will be responsible creating processes for monitoring the performance of Get Covered Illinois’ systems, vendors, and operations. This position offers an exciting opportunity to lead impactful initiatives in the technology and operations of Get Covered Illinois, contributing to the advancement of healthcare accessibility and affordability for Illinois residents. If you're ready to make a significant difference and drive positive change in the healthcare landscape, we encourage you to apply and join us in this important mission.

Get Covered Illinois is the State of Illinois’s new Health Insurance Marketplace. Get Covered Illinois’s mission is to increase access, enrollment, affordability, and choice for individuals and families by connecting them to health insurance plans and savings available through the Affordable Care Act. Get Covered Illinois provides pathways to coverage through a consumer-centric online application platform, a Customer Assistance Center, localized outreach and education strategies and a network of in-person assisters embedded in communities across the state that help Illinoisans enroll in the coverage that best meets their families’ needs. Get Covered Illinois is part of the Illinois Department of Insurance and has offices in Chicago and Springfield.

Why Work for Illinois?

Working with the State of Illinois is a testament to the values of compassion, equity, and dedication that define our state. Whether you’re helping to improve schools, protect our natural resources, or support families in need, you’re part of something bigger—something that touches the lives of every person who calls Illinois home.

No matter what state career you’re looking for, we offer jobs that fit your life and your schedule—flexible jobs that provide the gold standard of benefits. Our employees can take advantage of various avenues to advance their careers and realize their dreams. Our top-tier benefits and great retirement packages can help you build a rewarding career and lasting future with the State of Illinois.

Essential Functions

• Independently develops, implements, and performs ongoing administration of the Quality Assurance (QA) Program and related functions for Get Covered Illinois (GCI): 
    • Validates that QA strategies developed by GCI vendors and state staff meet industry standards and support program needs; oversees the implementation of activities outlined in the vendor organizations’ quality-related programs and processes; 
    • Coordinates engagement of GCI vendors and state staff to ensure successful adoption of QA strategies; 
    • Reviews standard operating procedures (SOP) of client-facing vendor positions and activities; 
    • Reviews QA artifacts, such as test plans, QA plans, test results, and call center QA monitoring programs and criteria and call center metrics, to assess performance and level of risk to GCI systems and program operations.
• Develops, implements, and administers processes to monitor, evaluate, and quantify vendor performance via data-driven practices: 
    • Creates and executes processes for Service Level Agreement (SLA) monitoring of vendor contracts; 
    • Analyzes vendor performance using all available data (SLAs, surveys, audit findings, call recordings, defect tracking, reporting, SOPs) and determines root cause of underperformance; 
    • Collaborates with GCI leadership across the organization to develop performance improvement plans in instances where vendors are underperforming.
• Implements, monitors, and adjusts improved business processes to gain operational efficiencies and institute best practices for the Quality Assurance Program and related functions: 
    • Makes recommendations to the Deputy Director of Customer Assistance Center and other GCI leaders concerning goals and objectives for all programmatic functions; 
    • Implements and evaluates new and revised processes and procedures; prepares reports and manuals documenting study results and recommending changes to improve operations; 
    • Participates in the development of performance measures with the business unit; 
    • Recommends improvements and monitors changes to ensure their effectiveness.
• Ensures adherence to industry-specific regulations, standards, and compliance requirements by GCI staff and vendors: 
    • Conducts research on federal and state regulatory requirements, industry standards and best practices; 
    • Evaluates GCI’s processes and services and make recommendations for improvements to increase operational efficiencies and regulatory compliance; 
    • Provides guidance to GCI staff and vendors on continuous improvement initiatives related to operational efficiency and regulatory compliance.
• Performs other duties as required or assigned which are reasonably within the scope of duties enumerated above.

Minimum Qualifications

• Requires knowledge, skill, and mental development equivalent to completion of four (4) years of college, preferably with courses in business or public administration.
• Requires two (2) years of responsible administrative experience in a public or business organization.
 

Preferred Qualifications

• Prefers two (2) years of experience analyzing technology systems and processes. 
• Prefers two (2) years of experience analyzing data. 
• Prefers strong understanding of software development life cycle (SDLC) and quality assurance methodologies. 
• Prefers strong understanding of contact center and related operations.
• Prefers experience working on the Affordable Care Act (ACA). 
• Prefers experience working on Medicaid or other healthcare programs. 
• Prefers experience with contracts. 

Specialized Skills

• Of the two (2) years of administrative experience noted above, requires two (2) years of experience analyzing technology systems, which includes design, testing, monitoring, and reporting processes.
• Of the two (2) years of administrative experience noted above, requires two (2) years of experience analyzing qualitative and quantitative levels of health information data.
 

Conditions of Employment

• Requires the ability to pass a background check.
• Requires ability to travel in the performance of duties, with overnight stays as appropriate.
• The conditions of employment listed here are incorporated and related to any of the job duties as listed in the job description.

About the Agency

The Department of Insurance (DOI) regulates the insurance market in the State of Illinois including, but not limited to, licensing and educating insurance agents, investigating Workers Compensation fraud, and examining the operations and finances of insurance companies domiciled in the state. We are committed to protecting consumers and regulating the insurance industry with innovation and efficiency. DOI has approximately 220 employees who are split between our Chicago and Springfield offices.

State of Illinois employees enjoy a robust benefit package, including:

• Health, Life, Vision, and Dental Insurance
• 13 Paid Holidays annually, 14 on even numbered years
• 10-25 days of Paid Vacation time annually - (10 days in year one of employment)
• 12 Paid Sick Days annually (sick days carry over from year to year)
• 12 Weeks Paid Maternity/Paternity Leave
• 3 Paid Personal Days annually
• Pension Plan
• Deferred Compensation Program and other pre-tax benefit programs (Medical/Daycare)
• Flexible work schedules may be available, dependent upon position
• Tuition Reimbursement Program and Federal Public Service Loan Forgiveness Program eligibility

Visit https://www2.illinois.gov/cms/benefits/Pages/default.aspx for more information about our benefits.