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Serco is seeking a motivated Assistant Program Director for Medical Claims Review to join our talented and fast-paced Public Sector Solutions team in supporting CMS’ implementation of the Payment Error Rate Measurement (PERM) Program to produce national Medicaid and Children’s Health Insurance Program (CHIP) improper payment estimates as required by the Payment Integrity Information Act of 2019 (PIIA).
As part of this effort, Serco would execute the PERM review contract which includes collection of state eligibility policies and medical records; medical reviews, data processing reviews, and eligibility reviews of selected state Medicaid and CHIP fee-for-services (FFS) and managed care claims; and supporting state and national reporting and development of corrective actions based on findings. The Assistant Program Director for Medical Claims Review would be responsible for management the medical and claims review, ensuring optimal delivery of program processes and operations, as well contract deliverable and budget management.
The candidate in this position ideally brings unique combination of extensive program management experience and subject matter expertise in medical claims verification, including medical records review and claims processing review for the Medicaid and Children’s Health Insurance Program. The position also is responsible for the business and system processes to coordinate and optimize multiple aspects medical and claims review operations.
Hybrid or full-time remote work. This is position is contingent on contract award.
In this role, you will:
Competencies
Required Qualifications
If you are interested in supporting our mission and working with a passionate team - then submit your application now for immediate consideration. It only takes a few minutes and could change your career!
Serco Inc. (Serco) is the Americas division of Serco Group, plc. In North America, Serco’s 9,000 employees strive to make an impact every day across 100 sites in the areas of Defense, Citizen Services, and Transportation. We help our clients deliver vital services more efficiently while increasing the satisfaction of their end customers. Serco serves every branch of the U.S. military, numerous U.S. Federal civilian agencies, the Intelligence Community, the Canadian government, state, provincial and local governments, and commercial clients. While your place may look a little different depending on your role, we know you will find yours here. Wherever you work and whatever you do, we invite you to discover your place in our world. Serco is a place you can count on and where you can make an impact because every contribution matters.
To review Serco benefits please visit: https://www.serco.com/na/careers/benefits-of-choosing-serco. If you require an accommodation with the application process please email: careers@serco-na.com or call the HR Service Desk at 800-628-6458, option 1. Please note, due to EEOC/OFCCP compliance, Serco is unable to accept resumes by email.
Candidates may be asked to present proof of identify during the selection process. If requested, this will require presentation of a government-issued I.D. (with photo) with name and address that match the information entered on the application. Serco will not take possession of or retain/store the information provided as proof of identity. For more information on how Serco uses your information, please see our Applicant Privacy Policy and Notice.
Serco does not accept unsolicited resumes through or from search firms or staffing agencies without being a contracted approved vendor. All unsolicited resumes will be considered the property of Serco and will not be obligated to pay a placement or contract fee. If you are interested in becoming an approved vendor at Serco, please email Agencies@serco-na.com.
Serco is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.
Full Time
$174k-209k (estimate)
03/17/2024
04/16/2024
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