Federal Healthcare Programs SME
Job Summary
Working remotely or in a hybrid capacity if local to Maryland, the Federal Healthcare Programs Subject Matter Expert will provide strategic advice and expertise to support the Centers for Medicare & Medicaid Services (CMS) in enhancing program integrity and preventing fraud, waste, and abuse within federal healthcare programs.
Key responsibilities
- Provide thought leadership on CMS Program Integrity programs and advise on modernization opportunities
- Monitor industry trends and best practices related to healthcare fraud detection and prevention
- Facilitate client-facing meetings and serve as a liaison to CMS stakeholders and system owners
Required qualifications
- Experience in evaluating and overseeing federal healthcare programs, particularly Medicare and Medicaid
- Comprehensive knowledge of HHS regulations and the Medicare Program Integrity Manual (PIM)
- Strong understanding of Medicare and Medicaid business processes and program integrity requirements
- Ability to obtain and maintain a Public Trust clearance
- Must have lived in the United States for 3 out of the past 5 years
Complete Job Description
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