Agency : Department of Insurance
Class Title : EXECUTIVE II - 13852
Skill Option : None
Bilingual Option : None
Closing Date / Time : 03 / 21 / 2025
Salary : $6,339 - $9,178 (Anticipated starting salary non-state $6,339 / CBA language applies)
Job Type : Salaried
Category : Full Time
County : Cook
Number of Vacancies : 1
Plan / BU : RC062
This position is a union position; therefore, provisions of the relevant collective bargaining agreement / labor contract apply to the filling of this position.
All applicants who want to be considered for this position MUST apply electronically through the illinois.jobs2web.com website. State of Illinois employees should click the link near the top left to apply through the SuccessFactors employee career portal.
Applications submitted via email or any paper manner (mail, fax, hand delivery) will not be considered.
Posting Identification Number 45465
- Answer all application questions thoroughly. DO NOT STATE "SEE RESUME".
Position Overview
The Carrier Integration Business Analyst position is responsible for driving resolution of identified issues and supporting business solutions for the products and programs at Get Covered Illinois, specifically as they relate to the integration of enrollment activities between GCI’s enrollment platform and participating carrier systems. The Business Analyst works closely with internal GCI teams, vendors, and insurance carriers to analyze and resolve issues and identify new solutions and processes. The Business Analyst is expected to maximize current and new technology capabilities and business processes relevant to enrollment functional areas within GCI’s systems to develop solutions to improve enrollment data accuracy, support workflows and improve efficiencies. We invite all qualified candidates to apply.
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
Serves as the statewide Marketplace Carrier Integration Business Analyst for the State-Based Marketplace Division : serves as an expert on content, structure, and format of source data for health plan enrollment transaction information; directs and collaborates with IT vendors, state technical staff and carriers to improve system performance and enrollment data accuracy; manages the initial migration from HealthCare.gov and ongoing maintenance of health insurance enrollment data; performs triage, analysis, and quality assurance on business systems and data, with specific focus on EDI / Enrollment transactions; documents and organizes system issues, actual and expected results, impacted populations, and relevant business rules; directs carrier system onboarding, including working with IT vendors on new carrier setup and connectivity, coordinating and reviewing 834 testing, establishing carrier user accounts, coordinating payment processing setup with IT vendors & carriers, connecting carriers to SBE documentation, shared files, state systems, etc.; identifies populations impacted by enrollment or system issues by leveraging various data sources; identifies and manages data correction associated with system issues, assuring best practices are followed; identifies and manages areas for improvement of system and business processes for future implementation; communicates with internal and external stakeholders regarding product issues and coordinates follow-up actions; oversees the annual renewal process, including implementation batch schedules and activities with Get Covered Illinois’s (GCI’s) IT vendors, coordinating manual operational work (corrections, manual plan selections, etc.), reviewing batch renewal outcomes, and working with carriers on updates to their annual renewal notices; confers with senior leadership when urgent problems are identified.Essential Functions Cont'd
Develops and implements key aspects of business processes and system development as related to enrollment data : assists with conducting research to develop, evaluate, and implement operational unit policies, procedures, and guidelines; identifies potential areas of operational concern, provides guidance and direction to vendors, proposes policy and business process options addressing those concerns, and raises these issues to senior leadership for resolution; promotes a collaborative team environment; serves as subject matter expert and agency leader for enrollment transactions (834 and 820), GCI enrollment and reconciliation platforms, provider directory, and other related system areas; manages 834 rejections, works with carriers to resolve 834 issues; collaborates with business teams and IT vendors to ensure technical support needs for carriers are identified and provided; manages provider directory data issues raised by consumers and carriers, including working with GCI’s IT vendors to oversee corrections; provides technical assistance in the development and distribution of user guides, training materials, and reference materials as it relates to EDI, enrollment, and carrier integration to ensure stakeholders are informed; manages plan certification processes, including working with carriers and GCI’s IT vendors to update plan data and statuses; collaborates with the GCI appeals team, including the review of user and case history information, system activity etc.; serves as cross-functional team player who will step in, as needed, to support integration of enrollment data between Carrier and Exchange systems, including testing, and requirements gathering; manages and facilitates GCI / carrier operations team meetings and other workgroups as necessary; manages and supports User Acceptance Testing (UAT) processes, including logging, documenting, and prioritizing defects; develops and reviews presentation materials; presents materials and answers questions as needed; provides technical assistance in creating and implementing robust corrective action plans that sustain short and long-term solutions; shares educational and informational materials with Division staff for staff development and learning purposes; assists senior leadership with special projects within the designated time frames and format.Oversees the enrollment data reconciliation program serving GCI and participating carriers, ensuring enrollment data is accurate, complete and in sync, and enrollment transactions are sent and received timely : oversees federal enrollment reporting processes; develops and implements enrollment data reconciliation processes between carriers, GCI, and GCI’s IT vendors; creates reports that provide insight into enrollment data issues; ensures required federal enrollment data reporting is delivered accurately and timely to IRS and Centers for Medicare and Medicaid Services (CMS); completes extensive research and tracks data reconciliation work and impacts to 1095 tax form and federal data reporting from enrollment system or data issues.Performs other duties as required or assigned which are reasonably within the scope of the 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 at least two (2) years of experience working with health insurance enrollment systems.Prefers at least three (3) years of business analysis or IT system analysis experience.Prefers at least three (3) years of experience working with ASC X12 TR3 5010 834, 820 file types.Prefers at least three (3) years of experience with strong analytical skills involving root cause analysis, business case development, gap analysis, process mapping, requirements management, design documentation.Prefers at least three (3) years of experience refining business and system needs into clear and concise requirements that can easily be understood by technical and non-technical groups.Prefers at least three (3) years of experience with systems testing, to include developing and executing test cases.Prefers Certification related to business analysis or project management such as PMI-PBA, PMP, or the CBAP.Prefers at least three (3) years of experience working with XML, JIRA, Confluence, or related software.Prefers a bachelor’s degree in business, information technology, or another related field.Prefers a Master’s Degree in business or public administration, with coursework in areas such as economic theory, accounting and finance, organizational theory, and operations research.Specialized Skills
Of the two years of experience above, requires at least two (2) years of experience working with health insurance enrollment systems.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 Insurance13 Paid Holidays annually, 14 on even numbered years10-25 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 Leave3 Paid Personal Days annuallyPension PlanDeferred Compensation Program and other pre-tax benefit programs (Medical / Daycare)Flexible work schedules may be available, dependent upon positionTuition Reimbursement Program and Federal Public Service Loan Forgiveness Program eligibilityVisit https : / / www2.illinois.gov / cms / benefits / Pages / default.aspx for more information about our benefits.
Work Hours : M-F; 8 : 30am - 5 : 00pm
Work Location : 115 S. LaSalle Street, 13th Floor, Chicago, IL 60603
Agency Contact Email : DOI.HR@illinois.gov
Posting Group : Leadership & Management
This position DOES contain “Specialized Skills” (as that term is used in CBAs).
APPLICATION INSTRUCTIONS
Use the “Apply” button at the top right or bottom right of this posting to begin the application process.
If you are not already signed in, you will be prompted to do so.
State employees should sign in to the career portal for State of Illinois employees – a link is available at the top left of the Illinois.jobs2web.com homepage in the blue ribbon.
Non-State employees should log in on the using the “View Profile” link in the top right of the Illinois.jobs2web.com homepage in the blue ribbon. If you have never before signed in, you will be prompted to create an account.
If you have questions about how to apply, please see the following resources :
State employees : Log in to the career portal for State employees and review the Internal Candidate Application Job Aid
Non-State employees : on Illinois.jobs2web.com – click “Application Procedures” in the footer of every page of the website.
The main form of communication will be through email. Please check your “junk mail”, “spam”, or “other” folder for communication(s) regarding any submitted application(s). You may receive emails from the following addresses :
donotreply@SIL-P1.ns2cloud.comsystems@SIL-P1.ns2cloud.com
Salary : $6,339 - $9,178
