Deputy Center Director (Oversight and Enforcement Policy), Center for Program Integrity

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 program integrity programs and provides strategic direction for CMS, the states, and law enforcement partners.
• Directs the development of Medicare, Medicaid, and Marketplace program integrity strategy and tactics for fee-for-service and managed care financing.
• Plans and develops methods to monitor program integrity efforts, including provider enrollment, administration, and coordination of CMS's efforts to curb fraud and abuse in the Medicare, Medicaid, and Marketplace programs.
• Manages all facets of program integrity functions for Medicare Administrative Contractors and Medicare Integrity Program contractors and manages all Medicare and Medicaid program integrity enforcement activities.

Requirements

Conditions of Employment

• U.S. Citizenship required.
• Background and/or Security Investigation required.
• One year SES probationary period required.
• The Ethics in Government Act, PL 95-521 requires the applicant selected for this position to submit a financial disclosure statement, SF-278, prior to assuming the SES position, annually, and upon termination of employment.
• Status applicants must submit a copy of their most recent SF-50, Notification of Personnel Action, which verifies status.
• All initial appointments to an SES position are contingent on approval from OPM's Qualifications Review Board unless the selectee has successfully participated in an OPM approved SES Candidate Development Program.
• All male applicants born after December 31, 1959, must have registered for the selective service. You will be required to sign a statement certifying his registration, or the applicant must demonstrate exempt status under the Selective Service Law.
• Only experience obtained by the closing date of this announcement will be considered.

Qualifications

All competitive candidates for SES positions with the Federal Government must demonstrate leadership experience indicative of senior executive level management capability. To meet the minimum qualification requirements for this position, you must show in your resume that you possess the Fundamental Competencies, five Executive Core Qualifications, and the Professional/Technical Qualifications listed below. Evidence of this experience must be incorporated into your five page resume. Separate narratives for the Executive Core Qualifications and/or Professional/Technical Qualifications will not be accepted or considered. Typically, experience of this nature is gained at or above the GS-15 grade level in the Federal service, or its equivalent with state or local government, the private sector, or nongovernmental organizations.

Fundamental Competencies:
Interpersonal Skills, Oral Communication, Integrity/Honesty, Written Communication, Continual Learning, and Public Service Motivation.

Executive Core Qualifications (ECQs)

Leading Change: The ability to bring about strategic change, both within and outside the organization, to meet organizational goals. Inherent to this ECQ is the ability to establish an organizational vision and to implement it in a continuously changing environment.

Leading People: The ability to lead people toward meeting the organization's vision, mission, and goals. Inherent to this ECQ is the ability to provide an inclusive workplace that fosters the development of others, facilitates cooperation and teamwork, and supports constructive resolution of conflicts.

Results Driven: The ability to meet organizational goals and customer expectations. Inherent to this ECQ is the ability to make decisions that produce high-quality results by applying technical knowledge, analyzing problems, and calculating risks.

Business Acumen: The ability to manage human, financial, and information resources strategically.

Building Coalitions: The ability to build coalitions internally and with other Federal agencies, State and local governments, nonprofit and private sector organizations, foreign governments, or international organizations to achieve common goals.

Professional/Technical Qualifications (PTQs)

This position also requires that you possess PTQs that represent knowledge, skills, and abilities essential for success in this role. The following PTQs must be evident in your resume.

Demonstrated knowledge and experience in managing health care delivery, program integrity, utilization management, or public health program functions within a large-scale health plan/program, including the critical social, political, and economic forces that affect them.

Comprehensive knowledge of laws, policies, and regulations that apply to the administration of health care delivery and program integrity and a demonstrated ability to use this knowledge and associated metrics to assess and improve program effectiveness, management processes, and systems to achieve organizational priorities and results.

Demonstrated experience, in a senior leadership position, dealing and negotiating with a wide range of senior level officials in various government agencies, law enforcement organizations, and/or public and private organizations on complex and controversial issues concerning health care programs, including the protection of the integrity of these programs.

It is STRONGLY recommended that you visit the following Office of Personnel Management (OPM) webpage for more information regarding the Fundamental Competencies and ECQs.
https://www.opm.gov/policy-data-oversight/senior-executive-service/executive-core-qualifications/#url=Overview

If selected, you will be required to complete an ECQ package by drafting narratives for each of the ECQs for submission and certification by an OPM Qualifications Review Board (QRB) in order to be placed in this position. If you are currently serving in a career SES appointment, are eligible for reinstatement into the SES, or have successfully completed an SES Candidate Development Program approved by the Office of Personnel Management (OPM), you will not need to draft the ECQs.

Education

This job does not have an education qualification requirement.

Additional information

Salary for SES positions varies depending on qualifications. The annual salary range is found at the top of this announcement. The selectee for this position may be eligible for annual performance bonuses and performance-based pay adjustments.

Veteran's Preference does not apply to the SES.
Federal agencies may request information regarding the vaccination status of selected applicants for the purposes of implementing other workplace safety protocols, such as protocols related to masking, physical distancing, testing, travel, and quarantine.

Workplace Flexibility at CMS: CMS offers flexible working arrangements and allows employees the opportunity to participate in telework combined with alternative work schedules at the manager's discretion. This position may be authorized for telework. Telework eligibility will be discussed during the interview process.

To ensure compliance with an applicable preliminary nationwide injunction, which may be supplemented, modified, or vacated, depending on the course of ongoing litigation, the Federal Government will take no action to implement or enforce Executive Order 14043 Requiring Coronavirus Disease 2019 Vaccination for Federal Employees. Therefore, to the extent a federal job announcement includes the requirement to be fully vaccinated against COVID-19 pursuant to Executive Order 14043, that requirement does not currently apply. Positions with vaccination requirements under authority(ies) separate and distinct from Executive Order 14043 will be clearly identified. HHS may continue to require documentation of proof of vaccination to ensure compliance with those policies. Health and safety protocols remain in effect, in accordance with CDC guidance and the Safer Federal Workforce Task force. Consistent with current guidance, workplace safety protocols will no longer vary based on vaccination status or otherwise depend on the availability of vaccination information. Therefore, to the extent a job announcement states that HHS may request information regarding the vaccination status of selected applicants for the purposes of implementing workplace safety protocols, this statement does not currently apply.