Duties. Serve as a subject-matter expert, providing technical advice and direction to a staff of public affairs specialists in day-to-day media relations work. Serve as the point-of-contact for news media at issues meetings, conferences, Congressional hearings, and other CMS-related events. Liaise with high-level officials at the Office, Agency, or Department level, as well as OMB/White House, also serving as a liaison to similarly placed executi...
Duties. Leads and directs the development of the requirements, methods, standards, policies, procedures, and budget guidelines for Medicare FFS claims processing related activities. Provides operational expertise to the development and implementation of Agency policies, regulations, procedures, new payment models and legislative proposals, taking into consideration the impacts on affected stakeholders and business processes. Coordinates modificat...
Duties. Serves as the technical expert and senior advisor to the Director providing architectural and strategic guidance on IT applications and systems. Advise technical specialists that plans, develops, schedules DMID applications and systems including independent analyses and alternative studies, COTS products and other technology tools studies. Presents information, data, and recommendations that are representative of thorough analysis of the ...
Duties. Serves as an Article II appointed hearing officer involving a variety of health care organization types and CMS programmatic areas including disputes over Medicare Advantage risk adjustment data validation. Drafts legal documents such as decisions and orders. performs legal cite research and analyzes legal documents to develop the facts in a case and determine the appropriate course of action for bringing legal questions to resolution. Ma...
Duties. Analyze and evaluate changes in program plans, objectives and funding and their effect on financial program milestones. Research, compile, and analyze information and data for a wide variety of regular and special reports requested by the organization, DHHS, OMB, Congress, and others. Review and edit narrative justifications prepared by program officials. Work to improve or develop financial management systems and related policies, goals ...
Duties. Serves as a Contracting Officer Representative (COR) on multimillion-dollar contracts, and/or task orders. Provides technical guidance to staff on procurement process and program budget considering OC policies and procedures, Federal Acquisition Regulations (FAR), regulations, and Agency policies. Coordinates with the Contracting Officer (CO) on all pre-award and post-award functions of assigned contracts, most of which are characterized ...
Duties. Work with digital product teams in Group (especially human-centered design and research teams) to evaluate how legislative and policy changes Medicaid and CHIP may affect the digital products. Provide consultation and technical assistance on Medicaid and CHIP policy issues to the digital product teams in Group. Help establish consistent methodologies and definitions for Medicaid and CHIP data, by working with data analysts, policy SMEs in...
Duties. Develop, interpret, apply, and work with states and stakeholders to implement policy related to Medicaid or CHIP eligibility, enrollment and/or managed care. Analyze polices related to eligibility, enrollment, and managed care to: Identify and prioritize important issues, Assess impact on Agency programs and policies, Discern budgetary and fiscal implications, and Assess impact on legislative initiatives. Serve as a subject matter expert ...
Duties. Identify and analyze issues, problems, and challenges facing the organization. formulate and evaluate possible courses of action for resolving them. draw conclusions based on relevant facts. and recommend solutions to management. Individually or as a team member, participate in surveys, studies and other investigations of management practices and administrative operations to determine the adequacy of present systems and to improve organiz...
Duties. Independently review and evaluate financial program payments, investigate fraud, waste, and abuse allegations, conduct program integrity reviews, and study financial systems. Analyze, develop, implement, and modify operating policy and procedures relating to program integrity. Provide technical assistance to stakeholders (e.g., Medicare, Medicaid, and/or private insurance that provide health care and drug services, and Providers), on CMS ...
Duties. Advocate on behalf of the user to the development team and liaise with program counterparts to translate customer needs into requirements that will lead to the development of product features. Facilitate an agile software development process to drive towards predictability and consistency in delivery. Track dashboard metrics and user satisfaction to measure performance and functionality of products, services, and features. Define the prog...
Duties. Conduct analyses of the quality and performance of HHS health and human services programs. Provide statistical/research information and justification on the operational aspects of specific plan-focused projects. Lead in the development of clearly written and concise issue papers and talking points for senior staff when needed. Prepares reports to recommend new or revised standards and criteria in order to improve operational efficiency. U...
