CASY-MSCCN Jobs

Position Description

Serco is seekinga motivated Program Director to join our talented and fast-paced Public Sector Solutions team in supporting CMS’ implementation of the Payment Error Rate Measurement (PERM) Program to produce national Medicaid and Children’s Health Insurance Program (CHIP) improper payment estimates as required by the Payment Integrity Information Act of 2019 (PIIA).

As part of this effort, Serco would execute the PERM review contract which includes collection of state eligibility policies and medical records; medical reviews, data processing reviews, and eligibility reviews of selected state Medicaid and CHIP fee-for-services (FFS) and managed care claims; supporting state and national reporting; and development of corrective actions based on findings. The Program Director position would be responsible for program management, ensuring optimal integration and delivery of program processes and operations, as well contract and financial management for the PERM Program.

The candidate in this position ideally brings unique combination of extensive program management and subject matter expertise in health insurance eligibility and/or claims processing policy, particularly for the Medicaid and Children’s Health Insurance Program, as well as technical understanding of program integrity or audit processes, to coordinate and optimize multiple aspects of payment error rate measurement operations.

Hybrid or full-time remote work. This is position is contingent on contract award.

In this role, you will:

• Serve as the primary point of contact with the CMS COR.

• Responsible for timely completion of all tasks, financial management and reporting.

• Direct all aspects of the day-to-day operations of the project and financial management, and aspect of the PERM contract.

• Oversee performance of the eligibility, medical and claims reviews for estimating Medicaid and CHIP improper payments – including business processes, staffing, training, facilities, quality assurance, IT (systems, integration and security); innovation and improvements, and communications to states, providers and other stakeholders

• Serve as the primary point of contact for PERM statistical contractor and subcontractors.

Competencies

• Proven management of large government program or contracts – including program policies, processes, operations, training, quality assurance, IT systems, staffing and financial management;

• Strong working knowledge of state Medicaid and CHIP policies, programs and operations.

• Extensive expertise in working with states on Medicaid and CHIP program

• Experience working with Medicare, Medicaid or CHIP auditing and/or program integrity projects;

• Demonstrated capabilities in qualitative and quantitative research and analysis, especially related to CMS programs;

• Strong leadership and organizational skills;

• Exceptional interpersonal skills with ability toestablish and maintain effective working relationships;

• Ability to communicate effectively, both strong orally and written skills, with government and state stakeholders.

• Demonstrated good judgment, a well-developed sense of propriety, political acumen, the ability to think constructively.

• Ability to deal with complex and changing policy and political environment.

• Enjoy working in fast-paced and collaborative team environment.

Qualifications

Required Qualifications

• A Bachelors or Master’s degree in public policy or administration, business administration or management, or related degree’

• A minimum of five (5) years project management experience working on large complex government projects, budgets, and staff;

• A minimum of three (3) years of experience working with state Medicaid and CHIP

• Supervisory/Managerial experience related to file/record management, performance of medical documentation reviews

• Working experience with electronic medical records or electronic transmission of medical record

• Preferably five years working in Medicaid and/or CHIP at a state or national level with three of those years working with states’ claims processing systems and/or the medical review process.

If you are interested in supporting our mission and working with a passionate team - then submit your application now for immediate consideration. It only takes a few minutes and could change your career!

Company Overview

Serco Inc. (Serco) is the Americas division of Serco Group, plc. In North America, Serco’s 9,000+ employees strive to make an impact every day across 100+ sites in the areas of Defense, Citizen Services, and Transportation. We help our clients deliver vital services more efficiently while increasing the satisfaction of their end customers. Serco serves every branch of the U.S. military, numerous U.S. Federal civilian agencies, the Intelligence Community, the Canadian government, state, provincial and local governments, and commercial clients. While your place may look a little different depending on your role, we know you will find yours here. Wherever you work and whatever you do, we invite you to discover your place in our world. Serco is a place you can count on and where you can make an impact because every contribution matters.

To review Serco benefits please visit: https://www.serco.com/na/careers/benefits-of-choosing-serco . If you require an accommodation with the application process please email: careers@serco-na.com or call the HR Service Desk at 800-628-6458, option 1. Please note, due to EEOC/OFCCP compliance, Serco is unable to accept resumes by email.

Candidates may be asked to present proof of identify during the selection process. If requested, this will require presentation of a government-issued I.D. (with photo) with name and address that match the information entered on the application. Serco will not take possession of or retain/store the information provided as proof of identity. For more information on how Serco uses your information, please see ourApplicant Privacy Policy and Notice (https://www.serco.com/na/privacy-policy) .

Serco does not accept unsolicited resumes through or from search firms or staffing agencies without being a contracted approved vendor. All unsolicited resumes will be considered the property of Serco and will not be obligated to pay a placement or contract fee. If you are interested in becoming an approved vendor at Serco, please email Agencies@serco-na.com .

Serco is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.

Click here to apply now (https://careers-sercous.icims.com/jobs/63801/program-director/job?mode=apply&apply=yes&in_iframe=1&hashed=-1834477830)

New to Serco?

Join our Talent Community! (https://talent.serco-na.com/talentcommunity/signup)

ID 63801

Recruiting Location : Location US-DC-

Category Health/Medical

Position Type Full-Time

Security Clearance None

Telework Yes - May Consider Full Time Teleworking for this position