The Health Exchange Subject Matter Expert (SME) will serve as a highly skilled and experienced consultant during the proposal phase. This individual will play a key role in shaping Cayuse Civil Services’ proposal submission by providing expertise related to Health Exchange operations and strategic designs of Customer Support Center (CSC) solutions for health insurance.

Working closely with the proposal team, the SME will develop strategies, draft proposal content, provide pricing insights, and ensure the organization’s solution aligns with customer requirements. Leveraging their experience in health benefits exchange programs, the SME will improve Cayuse’s competitive response and set up a successful framework for future contract execution.

• Proposal Support
• Provide subject matter expertise in designing comprehensive Customer Support Center (CSC) solutions for health benefits exchanges.
• Assist in developing and articulating CSC strategies that are compliant with the RFP’s scope of work and align with the client’s objectives.
• Collaborate with the proposal team to draft and review proposal narratives, ensuring technical accuracy, relevance, and clarity.
• Identify and recommend effective operational policies and advanced technology solutions, such as AI chatbots, CRM integration, and workflow management, that enhance efficiency and customer experience.
• Support industry pricing analysis by offering insights into benchmarks, competitor strategies, and cost-effective solutions.
• Consult on resource allocation for proposal submission, including organizational charts, staffing approaches, and key personnel justifications. 

• Collaboration
• Work closely with cross-functional teams, including business development, capture management, operations, and pricing, to align proposal strategies with client expectations.
• Serve as a liaison between technical and non-technical teams to ensure clarity across all proposal components.
• Share insights and best practices based on experience with other health exchanges and CSC implementations. 

• Compliance and Competitive Edge
• Conduct quality assurance reviews of all proposal content to ensure alignment with the RFP’s language and requirements.
• Provide feedback and suggestions for improvement to ensure the proposal submission emphasizes Cayuse’s strengths and differentiators.

1. Education
• Required: Bachelor’s degree in Business Administration, Healthcare Administration, Public Health, or a relevant field OR equivalent work experience.
• Preferred: Master’s degree in a related area or advanced certifications in proposal strategies (e.g., Shipley Training or equivalent). 

1. Experience
• Required:
• At least 5 years of experience with health exchange customer Support centers or state/federal healthcare initiatives, including developing and supporting complex CSC operations for health benefits exchanges.
• Demonstrated success contributing to or managing federal or state-level proposal submissions in a consulting role.
• Experience with multi-channel customer service strategies (e.g., phone, chat, email) and technology-driven solutions like AI, CRM, and API integrations.
• Experience successfully supporting proposal teams in developing and submitting proposals with winning outcomes. 

• Preferred:
• Experience with Washington Healthplanfinder or other state health exchange portals.
• Understanding of Affordable Care Act (ACA) programs, including Qualified Health Plans and Medicaid. 

1. Skills and Competencies
• Strong expertise in health benefits exchange operations, including eligibility determination and enrollment systems.
• Excellent communication and writing skills, with the ability to craft high-quality proposal content that meets client expectations.
• Strategic thinker with problem-solving capabilities to recommend creative, efficient solutions that enhance customer service delivery.
• Adept at collaborating with diverse teams and managing multiple priorities within tight deadlines. 

1. Other Requirements
• Availability to begin work immediately as a 1099 consultant for proposal support.

Preferred Qualifications

• Participation in previous proposal efforts or consulting roles for state health exchanges.
• Familiarity with performance metrics and reporting requirements for CSC operations.
• In-depth experience with competitive pricing strategies for health exchange or customer service contracts.
• Advanced knowledge of innovations in health benefits customer support processes (e.g., chatbots, automation workflows). 

Working Conditions

• Location: Remote.
• Environment: Consulting-based role requiring flexible availability to meet proposal deadlines. Work may involve evening or weekend hours during critical phases of the proposal schedule.
• Physical Requirements: Standard home-office conditions. 

Key Deliverables During Proposal Phase

• Draft detailed proposal narratives aligned with the RFP requirements.
• Recommend staffing and operational strategies informed by experience with other health exchanges.
• Identify key performance measures and strategies for delivering on SLAs post-award.
• Review and provide feedback on the entire proposal package to ensure its comprehensiveness and quality.

Disclaimer

This job description outlines the responsibilities of the Subject Matter Expert during the proposal phase. It is designed to be flexible during the consulting engagement based on the evolving needs of the proposal team.

Other Duties: Please note this job description is not designed to cover or contain a comprehensive list of activities, duties or responsibilities that are required of the employee for this job.  Duties, responsibilities, and activities may change at any time with or without notice.

Cayuse is an Equal Opportunity Employer.  All employment decisions are based on merit, qualifications, skills, and abilities. All qualified applicants will receive consideration for employment in accordance with any applicable federal, state, or local law.