Federal Healthcare Programs Subject Matter Expert
S
SparksoftGovernment Healthcare IT
Remote/Hybrid if local to MarylandFull-TimeMiddle
Salary not disclosed
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Job Details
- Required Skills
- Data Analysis
Requirements
- Experience in the evaluation, administration, and oversight of federal healthcare programs (Medicare and Medicaid).
- Comprehensive knowledge of HHS regulations, the Medicare Program Integrity Manual (PIM), and Medicare and Medicaid program operations.
- Strong analytical and problem-solving skills for complex business and operational challenges.
- Proven ability to manage multiple projects and competing priorities in a deadline-driven environment.
- Effective verbal and written communication skills for stakeholder engagement.
- Associates degree or higher.
- Ability to obtain and maintain a Public Trust clearance.
- Lived in the United States 3 out of the past 5 years.
Responsibilities
- Provide thought leadership on the future direction of CMS Program Integrity programs and APS capabilities.
- Advise CMS leadership on strategic investments, modernization opportunities, and program enhancements.
- Apply federal healthcare program knowledge to provide analysis, solutions, and requirements for APS project teams.
- Interpret and apply HHS regulations, CMS policies, and the Medicare Program Integrity Manual to support program integrity initiatives.
- Analyze federal and industry data sources to support provider screening, sanctions, and fraud, waste, and abuse (FWA) detection activities.
- Facilitate client-facing meetings, including requirement gathering sessions and project meetings with CMS leadership.
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