Duties Principal participant in the formulation of operating policies and guidelines that address Equal Employment Opportunity (EEO) complaint processing at CMS to ensure that all complaints of alleged discrimination are promptly and fairly adjudicated. Drafts procedurally and legally sound settlement agreements in the informal and formal complaint processes. Drafts memor

Duties Serves as the Agency's strategic, operational and implementation leader for all managed care area programs within the Medicaid, CHIP and BHP programs. Establishes a vision for and leads the development of program policy related to Medicaid managed care, including payment policy regarding Medicaid Managed Care rates, benefits and coverage. Oversees the development,

Duties Provides authoritative clinical advice and guidance in the development of policies and transformational health care outcomes that incorporate the operational aspects of CMS programs, as well as drive quality and reduce costs. Advises Group leadership on the clinical and quality improvement activities necessary to ensure the successful completion of ideation, planni

Duties Utilize appropriate market research and statistical techniques to identify ways to improve services to program populations. Conduct analyses of survey data, including analyses of case mix adjustment of survey estimates of satisfaction with plan and provider performance. Represent the organization at briefings and other meetings regarding the justification and appro

Duties Interpret statute and develop Federal regulations, policy statements, and other program guidance. Conduct analysis of policy issues and topics, research background information, the origin of laws, and the intended impact in order to make effective policy recommendations. Develop, implement, and maintain operational requirements, including standard operating procedu

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 Develops the CMS budget, with input from other CMS components and in accordance with the agency's strategic plan and the Government Performance and Results Act. Formulates and presents all agency discretionary and mandatory budget data, including budget estimates for the Secretary's budget press conference, and final budget numbers for the Agency's Data Compendium.

Duties Coordinate all facets of the Division's work by providing the primary medical expertise and approving coverage decisions/related policies and mobilizing a diverse professional staff. Serve as a national expert and resource to HHS and CMS leadership, as well as other internal and external stakeholders, on the national coverage determinations and related coverage pol

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 Develop and conduct program and policy analyses to identify and understand the needs and preferences of HHS health and human services programs and the populations they serve. Plan, direct, and monitor activities involved in conducting surveys of program populations. Design, analyze, implement, and interpret studies regarding the influence of communications about di

Duties Interpret statute and develop Federal regulations, policy statements, and other program guidance relating to health insurance programs. Conduct analysis of policy issues and topics by researching background information, the origin of laws, and the intended impact in order to make effective policy recommendations. Develop, implement, and maintain operational require