Program Review Specialist, Sr.

Aptive; United States; Remote; USD 95,000 - 135,000; Full time

Job summary

Aptive is seeking a Senior Program Review Specialist to oversee federal health program reviews, ensuring eligibility, policy alignment, and evidence sufficiency. The role emphasizes clear, well-documented recommendations and consistent application of program criteria.

The candidate will establish reviewer guidance, calibrate processes, and drive improvements in review quality while safeguarding applicant information and maintaining meticulous records.

Qualifications

• Bachelor’s degree and 5+ years of relevant review experience.
• Ability to interpret statutes, regulations, policies or program requirements and apply them consistently.
• Experience assessing evidence, documenting findings and developing defensible written recommendations.
• Strong attention to detail and ability to identify gaps, inconsistencies and unsupported claims.
• Excellent written communication and ability to present findings to technical and non-technical audiences.
• U.S. work authorization required.

Responsibilities

• Lead end-to-end reviews of applications, submissions, or case files using approved policies, procedures, templates, and evaluation criteria.
• Assess eligibility, program alignment, documentation completeness, internal consistency, and the credibility of supporting evidence.
• Prepare clear review records documenting evidence considered, findings, unresolved issues, and the basis for recommendations.
• Develop and maintain standardized review checklists, decision trees, evidence matrices and reviewer job aids.
• Identify missing, unclear or inconsistent information and coordinate targeted clarification requests through the applicant communications function.
• Ensure review conclusions are traceable to the governing requirement and distinguish factual findings from professional judgment or recommendation.
• Conduct secondary reviews of complex, sensitive, or borderline cases and elevate interpretive questions through established channels.
• Lead reviewer calibration sessions to improve consistency, reduce rework, and document relevant guidance or precedents.
• Analyze recurring deficiencies and recommend updates to intake instructions, templates, SOPs and quality controls.
• Protect applicant information and maintain accurate records in the designated document repository and tracking system.

Skills

Policy interpretation

Documentation review

Analytical judgement

Written communication

Quality control

Education

Bachelor’s degree in public policy, healthcare administration, business administration, social sciences, law, compliance or a related field

Job description

Job Summary

Senior Program Review Specialist

Aptive is seeking a Senior Program Review Specialist to support a federal health program involving structured review of applications, submissions, or case documentation. The role will evaluate materials for eligibility, policy alignment, completeness, consistency, and evidentiary support and will develop clear, well-documented recommendations for government consideration.

The Senior Program Review Specialist will also help establish reviewer guidance, promote consistent application of program criteria, support resolution of complex cases, and improve review quality through calibration and continuous feedback.

The ideal candidate brings strong policy interpretation, analytical judgment, and documentation-review experience and can translate complex requirements into practical, repeatable review criteria.

Primary Responsibilities

• Lead end-to-end reviews of applications, submissions, or case files using approved policies, procedures, templates, and evaluation criteria.
• Assess eligibility, program alignment, documentation completeness, internal consistency, and the credibility of supporting evidence.
• Prepare clear review records documenting evidence considered, findings, unresolved issues, and the basis for recommendations.
• Develop and maintain standardized review checklists, decision trees, evidence matrices and reviewer job aids.
• Identify missing, unclear or inconsistent information and coordinate targeted clarification requests through the applicant communications function.
• Ensure review conclusions are traceable to the governing requirement and distinguish factual findings from professional judgment or recommendation.
• Conduct secondary reviews of complex, sensitive, or borderline cases and elevate interpretive questions through established channels.
• Lead reviewer calibration sessions to improve consistency, reduce rework, and document relevant guidance or precedents.
• Analyze recurring deficiencies and recommend updates to intake instructions, templates, SOPs and quality controls.
• Protect applicant information and maintain accurate records in the designated document repository and tracking system.

Minimum Qualifications

• Bachelor’s degree in public policy, healthcare administration, business administration, social sciences, law, compliance or a related field.
• Minimum of 5 years of experience performing technical, eligibility, compliance, policy or documentation reviews.
• Demonstrated ability to interpret statutes, regulations, policies or program requirements and apply them consistently to individual cases.
• Experience assessing evidence, documenting findings and developing defensible written recommendations.
• Exceptional attention to detail and ability to identify gaps, inconsistencies and unsupported claims in submitted materials.
• Strong writing skills and ability to communicate review findings clearly to technical and non-technical audiences.
• Ability to manage a steady volume of assignments while meeting turnaround and quality expectations.
• Legal authorization to work in the U.S.

Desired Qualifications

• Experience supporting VA, another federal health agency, Veterans’ programs, healthcare navigation, public benefits, or community-partnership initiatives.
• Experience reviewing nonprofit, volunteer, community-based, healthcare, or public-service organizations.
• Experience with credentialing, certification, eligibility, licensing, grants, claims, or other formal application-review processes.
• Experience developing review rubrics, checklists, standard work or knowledge-management resources.
• Familiarity with Lean methods, reviewer calibration and root-cause analysis.

About Aptive

About Aptive. Aptive partners with federal agencies to achieve their missions through improved performance, streamlined operations and enhanced service delivery. Based in Alexandria, Virginia, we support more than a dozen agencies including Veterans Affairs, Transportation, Defense, Homeland Security and the National Science Foundation. We specialize in applying technology, creativity and human-centered services to optimize mission delivery and improve experiences for millions of people who count on government services every day. Founded: 2012. Employees: 300+ nationwide.

EEO Statement

Aptive is an equal opportunity employer. We consider all qualified applicants for employment without regard to race, color, national origin, religion, creed, sex, sexual orientation, gender identity, marital status, parental status, veteran status, age, disability, or any other protected class. Veterans, members of the Reserve and National Guard, and transitioning active-duty service members are highly encouraged to apply. About Aptive: Aptive partners with federal agencies to achieve their missions through improved performance, streamlined operations and enhanced service delivery. Based in Alexandria, Virginia, we support more than a dozen agencies including Veterans Affairs, Transportation, Defense, Homeland Security and the National Science Foundation. We specialize in applying technology, creativity and human-centered services to optimize mission delivery and improve experiences for millions of people who count on government services every day. Founded: 2012. Employees: 300+ nationwide.