At CMS, we believe that at the core of our organization are the employees that carry out the Agency’s vision of advancing health equity, expanding coverage, and improving health outcomes.
About the role:
As a Nurse, you will provide clinical guidance as part of CMS program policy or support teams, responsible for interpreting applicable laws, regulations, and policies for CMS insurance programs.
What you’ll do:
- Identify trends and problem areas and recommends needed revisions to existing program policies, criteria, standards, and procedures.
- Coordinate with stakeholders to develop solutions to program problems.
- Work with CMS components on data interpretation, recovery audits, claims processing and payment, medical review, and appeals to ensure accurate implementation of clinical healthcare policy.
- Track effectiveness of corrective actions to identify, monitor, and mitigate program vulnerabilities and reduce improper payments.
Experience we’re looking for:
Assisting in identifying program vulnerabilities that impact medical/nursing elements of the healthcare delivery system.
Possession of a diploma, associate degree, bachelor’s degree, or master’s degree from a professional nursing educational program.
Proof of License/Registration is required and MUST be submitted at the time of application to verify possession of the license/registration listed above. Failure to submit proof of license/registration at the time of application WILL result in an ineligible rating. Please see the “Required Documents” section below for more information.
You MUST apply through USAJOBS to be considered.
To see the full list of qualifications and eligibility criteria, click apply to review the job announcement on USAJOBS.
Apply by 12/22/21!