Senior Advisor, Payment Operations

Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation (CMMI), Seamless Care Model Group (SCMG). As a Technical Advisor referred to here as a Senior Advisor, Payment Operations, GS-0301-14, you will lead Medicare payment operations, guiding Fee-For-Service (FFS) system changes, and coordinating care delivery model implementation across CMMI's SCMG.

Duties

• •Directs programming and policy changes for Medicare payment systems, ensuring new care models are implemented accurately and efficiently.
• •Tracks payment processes continuously to catch and fix problems before they affect model operations or participants.
• •Serves as the main point of contact between CMS groups, contractors, and Medicare Administrative Contractors to carry out technical payment changes.
• •Provides expert recommendations to program directors on policy changes, new initiatives, and ways to improve model operations.
• •Guides junior team members on payment processes and reviews their work to ensure quality and consistency.

Qualifications

ALL QUALIFICATION REQUIREMENTS MUST BE MET BY 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: Analyzing Medicare fee-for-service payment systems to identify technical requirements for implementing alternative payment or care delivery models; AND Advising agency leadership and internal stakeholders on Medicare payment policy to support the design, testing, or evaluation of value-based care models; AND Coordinating with Medicare contractors or CMS business components to implement payment system changes supporting new or existing care delivery initiatives; AND Preparing technical reports and briefings on Medicare payment operations to communicate findings and recommendations to agency officials or leadership. 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. Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/13089766