Division Deputy Director (Division of State Program Integrity)

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Program Integrity (CPI), Audits and Vulnerabilities Group (AVG). As a Supv.Health Insurance Specialist referred to here as a Division Deputy Director, Division of State Program Integrity, you will serve as technical expert and advisor providing guidance to State program integrity components on all Medicare and Medicaid program integrity enforcement activities. PRINCIPALES MISSIONS : Serving as a trusted advisor to the Division Director, Group Director, and senior Agency leadership on complex Medicaid program integrity issues including identifying emerging risks and recommending appropriate program responses. Managing and overseeing day-to-day operational activities related to Medicaid audits and State program integrity reviews, including eligibility determinations, medical loss ratio audits, and Recovery Audit Contractor (RAC) program oversight. Serving as a first-level supervisor for a team of highly technical employees and contractors, providing direction, coordination, and guidance to ensure mission goals related to fraud, waste, and abuse prevention are met. Assisting in the development of policies, regulations, and procedures for the Medicaid Integrity Program (MIP), including analyzing proposed legislative changes and assessing their impact on DSPI operations. Collaborating with CMS components, State Medicaid agencies, and other stakeholders to build an integrated national framework for Medicaid program integrity including State corrective action plans and providing technical support across programs. QUALIFICATIONS REQUISES : ALL QUALIFICATION REQUIREMENTS MUST BE MET WITHIN 30 DAYS OF THE CLOSING DATE OF THIS ANNOUNCEMENT. Your resume (limited to no more than 2 pages) must include detailed information as it relates to the responsibilities and specialized experience for this position. Evidence of copying and pasting directly from the vacancy announcement without clearly documenting supplemental information to describe your experience will result in an ineligible rating. This will prevent you from being considered further. In order to qualify for the GS-14 , you must meet the following: You must demonstrate in your resume at least one year (52 weeks) of qualifying specialized experience equivalent to the GS-13 grade level in the Federal government, obtained in either the private or public sector, to include: Implementing projects or processes to support States' Medicaid program integrity oversight activities; Advising leadership and stakeholders on Medicaid policies or processes that have multi-state or national impact; AND Coordinating projects or tasks across multiple stakeholders to meet organizational mission goals and objectives. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional, philanthropic, religious, spiritual, community, student, social). Volunteer work helps build critical competencies, knowledge, and skills, and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. Time-in-Grade: To be eligible, current Federal employees must have served at least 52 weeks (one year) at the next lower grade level from the position/grade level(s) to which they are applying. Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/12947606

Salaire : $143,913 – $187,093/an | Avantages : https://help.usajobs.gov/working-in-government/benefits

The Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) works in partnership with the entire health care community to improve quality and efficiency in an evolving health care system and provides leadership in the broader health care marketplace. CMS' effectiveness depends on the capabilities of a dedicated, professional staff that is committed to supporting these objectives. A career with CMS offers the opportunity to get involved in important national health care issues and be part of a dynamic, fast-paced, and highly visible organization. For more information on CMS, please visit: http://www.cms.gov/. HHS has a critical preparedness and response mission: HHS protects the American people from health threats, researches emerging diseases, and mobilizes public health programs with domestic and international partners. In support of this mission, HHS offers its employees the opportunity to contribute their unique skills through voluntary temporary