Medicaid Policy & Program Integrity Specialist

Centers-For-Medicare-and-Medicaid-Services; Atlanta (GA); On-site; USD 100,000 - 140,000; Full time

Job summary

Centers for Medicare and Medicaid Services seeks a Health Insurance Specialist (GS-0107-13) to lead Medicaid managed care policy development, evaluation, and oversight, including program integrity and FWA activities within the group’s scope.

Qualifications require at least one year of specialized experience at GS-12 level and evidence of experience with statutes, regulations, and program requirements. This role emphasizes technical guidance to states and stakeholders.

Qualifications

• Must meet all qualification requirements by the closing date.
• One year of specialized experience at GS-12 or equivalent.
• Experience with federal statutes, regulations, and program requirements.

Responsibilities

• Analyze, develop, and implement Medicaid managed care statutes and regulations.
• Provide technical guidance to states and stakeholders to ensure compliance.
• Assess program integrity risk and recommend improvements.

Skills

Medicaid managed care policy

Regulatory guidance

Program integrity

Job description

Centers for Medicare and Medicaid Services seeks a Health Insurance Specialist (GS-0107-13) to lead Medicaid managed care policy development, evaluation, and oversight, including program integrity and FWA activities within the group’s scope.

Qualifications require at least one year of specialized experience at GS-12 level and evidence of experience with statutes, regulations, and program requirements. This role emphasizes technical guidance to states and stakeholders.