Duties Advises on complex cost reporting, auditing, and accounting issues related to the Medicare Part A cost report and other highly technical financial and cost accounting payment issues. Trains new staff and Board Members on the cost report process; and consulting with senior level management, OGC, etc. to ensure consistency in auditing payment issues. Provides expert

Duties Maintains the appointment calendar for the Director, schedules appointments independently, reminds the supervisor of meetings, briefs the supervisor on the subject matter prior to the meeting and makes the administrative arrangements as required. Researches and assembles information about CMS programs from files and records to respond to inquiries. Revises or compo

Duties Identify trends and problem areas and recommends needed revisions to existing program policies, criteria, standards, and procedures. Coordinate with stakeholders to develop solutions to program problems. Work with CMS components on data interpretation, recovery audits, claims processing and payment, medical review, and appeals to ensure accurate implementation of c

Duties Make recommendations associated with sound management practices related to enterprise strategic planning. Deliver recommendations to senior officials about how significant human or financial resources are utilized, and how policies are incorporated into strategic plans. Direct, monitor, and report on major projects within OSPR's purview in support of enterprise str

Duties Provides technical expertise, guidance, and support on drug rebate and negotiation policies related to the Inflation Reduction Act of 2022. Serves as a leader on multi disciplinary teams, leading and providing guidance for the team to research, innovate, create, organize, and recommend new and amended national policies. Manages issues and information analysis, ensu

Duties Develops strategic plans in conjunction with program officials and Contracting Officer's Representatives (CORs). Prepares solicitation documents which incorporate required Federal Acquisition Regulations (FAR) and HHS policies and provisions. Performs cost/price analysis, including analysis of cost breakdowns to determine reasonableness and conformance to applicabl

Duties Develop, implement, and maintain operational requirements, including standard operating procedures, as well as databases to manage and analyze programmatic information such as routine and ad hoc reports, deliverables, and programmatic documentation. Analyze internal policies, processes, and procedures to assure increased efficiency in operations and implements them

Duties Reconcile cash, accounts receivable, accounts payable, and other general ledger accounts. Accomplish specific tasks on assignments requiring familiarity with, and use of a number of standard accounting principles, methods, and practices. Assists higher grade accountants by accomplishing segments of more complex projects. Perform analysis of debt collection and comm

Duties Direct, coordinate, plan, design, develop, and implement analyses of economic issues using mathematical models and statistical techniques. Respond to requests for conceptual and statistical analyses, particularly in the areas of health insurance coverage, drug expenditures, and medical expenditures. Prepare or oversee the preparation of statistical tabulations and

Duties Provide professional nursing advice and technical assistance to a variety of audiences. Provide expert clinical nursing and program perspective in the assessment of policies, projects, and data related to the measurement of quality, legislative, and administrative proposals. Consult with experts in the delivery of nursing services and health care to obtain informat

Duties Provides system support for the provisions in the Health Plan Management System (HPMS), a web enabled information system that serves a critical role in the business operations of the Medicare Advantage (MA) and Prescription Drug (Part D) programs. Evaluates technical guidance in support of proposed, modified, or new legislation and regulations, related to the IRA?s

Duties Develop program policy and operational guidance, including operations manuals, regulation text and preambles, briefing materials and talking points, change requests, correspondence, legislative proposals, and technical direction letters. Review and analyze drug policy issues such as cost effectiveness, cost minimization, overall drug therapy costs, and budget forec

Duties Conducts onsite inspections of health care delivery provided to beneficiaries to evaluate the quality of care, quality of life, and the provision of other services. Provides guidance and direction on survey issues to state agency (SA) staff. Formulates or recommends needed revisions or changes to existing program policies, criteria, standards, and procedures. Analy

Duties Conduct data science research with statistical and analytical tools used to analyze complex sets of data. Solve technical problems by writing code and explaining data architecture and design to both technical and non technical audiences, Develop project plans to ensure logistics are handled efficiently, identifying potential bottlenecks and resolving issues within

Duties Integrates program integrity activities and contracting into a strategic framework targeting the highest risk areas and health system issues focusing on preventing fraud, waste, and abuse. Develops and implements innovative program integrity initiatives. Provides executive leadership and direction in developing and implementing Medicare, Medicaid, and Marketplace p