Summary
This position is located in the Center for Program Integrity (CPI) at the Centers for Medicare & Medicaid Services (CMS). As the Deputy Center Director (Medicaid Program Integrity), you will provide executive leadership, direction and coordination for the management of a cohesive, agency-wide approach to ensuring program integrity across the Medicaid and Children's Health Insurance Program (CHIP).
Duties
Provides executive leadership and expert knowledge for the agency as it relates to Medicaid program integrity (PI) activities.
Directs the identification of program vulnerabilities and actions taken to formulate and implement methodologies to strengthen program integrity efforts emerging with fraud, waste, and abuse in the Medicaid and CHIP programs.
Provides strategic direction and oversight for CPI's engagement with State Medicaid agencies on program integrity activities, including the review and approval of State program integrity plans and corrective action plans.
Directs CPI's oversight of program integrity activities within Medicaid Managed Care Organizations (MCOs), including the review of encounter data, claims data, and managed care contract compliance.
Oversees CPI strategic planning, as well as the establishment of performance goals and measures for CPI and its staff.
Provides guidance to ensure appropriate liaison and coordination with the Department, other HHS Operating Divisions, other Federal agencies and other non-Federal organizations necessary to CPI’s program integrity operations.
How you will be evaluated
You will be evaluated on the quality and extent of your total accomplishments, experience, and education (if applicable). Your application will be rated and ranked by a Senior Executive Service (SES) Panel, comprised of at least three SES members, using only the information required within the application package. Applicants who do not demonstrate in their application sufficient possession of the ECQs and TQs will be determined ineligible for further consideration. Once the application process is complete, your resume and supporting documentation will be reviewed. If you meet minimum qualifications, your Application Package will be further reviewed to determine if you possess the Executive Core Qualifications (ECQ) and Technical Qualifications (TQ) listed above. ECQs and TQs must be thoroughly addressed within your two (2) page resume. Separate narratives will not be accepted or reviewed. Highly Qualified applicants may undergo one or more interviews and may be referred to the selecting official for further consideration. Upon selection, if not already a member of the SES serving under a career appointment, the individual selected must have his/her executive qualifications certified by the U.S. Office of Personnel Management's SES Qualifications Review Board (QRB) before appointment to this position. The selected individual's application will be forwarded to the OPM for review and certification by the QRB, unless the selectee provides evidence of their noncompetitive status (e.g., a current SES, an OPM QRB-certified SESCDP graduate, or SES reinstatement eligibility). Upon QRB certification, the selected individual will be required to serve a one-year probationary period. For more information regarding the SES, go to https://www.opm.gov/policy-data-oversight/senior-executive-service/.